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Breaking the chain of transmission in 2015: An inspiration from a victim – Augusta Vandy

January 8, 2015 By: Sheriff Mahmud Ismail

Back in October, the story of 15 year old Augusta Vandy shocked many people around the world. Augusta’s parents had died of the Ebola virus and just few days later, she started to show symptoms of Ebola. She and her neighbours frantically called the public emergency line- 117, while she waited (to no avail) for her to be picked up by the ambulance team. So Augusta took the hard decision of breaking the chain of transmission in her family. She moved to the balcony of their house where she passed a couple of nights- leaving her younger siblings- a 9-year-old and a 5-month-old baby inside the house. Augusta eventually died but she had succeeded in preventing her siblings from being infected!

We are moving into 2015 with a not so promising infection rate. As of 30th December 2014 Sierra Leone has recorded a total of 1,513 new cases- about 600 shy of the over 2,000 cases recorded in November. A big difference but certainly not good enough. There have been outbursts of the virus from time to time and from place to place. The recent developments in the sudden high number of cases in Kono and Koinadugu districts and the sustained high numbers coming from Port Loko, Bombali and Western Area (especially Western Urban) continue to remind us of the gaps in logistics, treatment and holding centers. Tonkolili district is also steadily recording new cases in spite of a sustained collaborative social mobilization drive by key government functionaries and descendants of that district.

Agreed! There has been significant progress in the response effort. As President Koroma puts it in his announcement of “Operation Western area Surge”: “We have significantly increased our capacity to defeat the virus. We have been able to increase the number of treatment centres from 1 to over 10… across the country. We have also been able to increase the holding bed capacity to over 800. These numbers will grow exponentially as the British Royal Engineers complete the last batch of the 700 bed capacity treatment centres over the next few weeks. We have also been able to increase our laboratory capacity from a single lab in Kenema….to 7 functional laboratories across the country with a combined capacity to test over a thousand samples a day. From a single doctor with expertise in this type of viral diseases, we now have many doctors and health workers with skills to tackle the outbreak. We have trained our own medical personnel with international support, and improved the skills of contact tracers, burial teams and call center operators…”

Therefore the operational front (117 emergency telephone line, ambulance and burial services) has also improved. Yet gaps still exist. Reports say, up to this point Kono district has only one holding center and it does not have a treatment center. Koinadugu’s steep topography still poses accessibility challenges in the district’s efforts to break the transmission chain. And despite the measures to isolate some affected districts and communities, people are still moving back and forth one way or the other.

There are also the challenges relating to cultural practices; some of the public are still caring for sick loved ones at home, washing and burying the dead without referring to the authorities. In fact, in Tonkolili, a group of people exhumed the dead whose ghost they believed was haunting their community! The consequence was a spike in new infections!

Overall, I think there is a strong link between the two challenges: logistical; and those cultural challenges. The fact is, for someone to sit by a mother, father, sister, wife or child and watch them suffer in pain- throwing up and stooling- without doing anything is very difficult indeed. People may wait for a some hours but if the situation worsens and the ambulance or burial team does not show up early enough (well that’s another problem, the stipulated time the public is expected to wait after reaching the 117 line is difficult to ascertain); then there is always the risk that a family member would take action and get infected in the process. But is this the rational thing to do?

And that brings me to the point about making hard decisions. Given the frightening reality that the consequence for coming into contact with infected persons or bodies is probably the loss of one’s own life, the public should be more convinced that it is better to endure the pain of not touching any sick person even if the person is a parent, a child or a sibling.

This is against the risk of putting the whole family on a ‘death row’. We have seen whole families of 5, 8, 10 and more people wiped out in trying to honour or care for one of their own. I acknowledge that it is indeed very difficult not to attend to a sick or dead family member but the Ebola virus is violently antagonistic to our humane cultural practices and the consequences are just too much to confront- too many people are dying needlessly. Augusta Vandy called the emergency line, I am sure she prayed for God’s intervention but she also knew she had to do something practically right.

So decisions like the one taken by the late Augusta Vandy should inspire the rest of Sierra Leone. Her story is very poignant: 15 years old Augusta’s parents had died of the Ebola virus. So when she started to show symptoms of Ebola, she and her neighbours frantically called the public emergency 117 number. While she waited (to no avail) for her to be picked up by the ambulance team, she moved to the balcony to keep away from her younger siblings-  a 9 year old and a 5 month old baby. Augusta eventually died but she had succeeded in preventing her two siblings from being infected.

This outbreak has inflicted too much pain on the ordinary people; it has terrorized our health care workers, derailed our economy, halted our development strides and reversed our gains as a nation. It must not linger too long; we must all muster the courage to stop this monstrosity from spreading and defeat it once and for all.

But to break the chain of transmission, we must make the right sacrifices and take practical actions. The young Augusta, by her bravery and true love, has taught us what to do in the face of death. In her heroism, she preferred to die alone for the rest of her family to live on. Let Sierra Leone be inspired: DON’T TOUCH, DON’T WASH, and DON’T BURY YOUR DEAD. REPORT TO THE HEALTH AUTHORITIES AND WAIT. HOWEVER LONG IT TAKES, BE PATIENT FOR THAT IS THE ONLY WAY OUT!

This is my resolution for 2015, what about you? As I wish all Sierra Leoneans a happy New Year, I urge you to take the challenge so that “Together, We Can Beat Ebola”!

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