Ebola outbreak, the urgent need for MRU strategy


By Joseph Dumbuya

They say when your neighbour’s house is on fire you should waste no time in rushing to her rescue. It would be foolhardy to ignore her and self-deceive into believing you can stop the fire from reaching your house by putting fire defences around your house. If anything, failure to help increases the chances of the fire spreading to your house.

This wise saying bears relevance to the measures the Ministry of Health and partner agencies are putting in place to stop the deadly Ebola disease from spreading into Sierra Leone.

Just to refresh your memory, the Minister leading government’s efforts against Ebola, Ms. Kargbo, caused consternation recently when following the fire incident at the Medical Stores  told a bewildered nation that the drugs destroyed by the fire had already expired. The Minister was trying to downplay the loss but it backfired spectacularly. She must be very lucky to cling on to her job.

While we’ve seen efforts at public health education, at least in Freetown, I’m not sure the same can be said of upcountry especially in the districts bordering Guinea which need it most. But you should not expect much when you have health officers from Freetown being ferried upcountry to do public education.

The publicity around the setting up of a national taskforce responsible for surveillance of the disease is arousing a lot of interest from a panic stricken public for the wrong reasons. Yes, there have been some efforts at awareness-raising in Freetown. At least Minister Miata Kargbo and the Chief Medical Officer (CDO) Dr. Brima Kargbo are constantly on radio to talk at us about what is being done in stopping the Ebola virus from reaching Sierra Leone and what to do and what not to do to avoid contracting the virus.

Even these efforts are not good enough. I think there is still need for a massive public health education strategy especially upcountry. I think the Ministry must engage civil society in the districts bordering with Guinea to take the lead in awareness-raising. With this, far more will be achieved with less resource. A few million Leones to civil society in each district to cover transport cost could be the magic wand.

These groups have the numbers, they have the expertise, they understand the environment and most importantly the people trust them more than per diem-seeking medical personnel from Freetown. The ministry should prepare the leaflets or brochures and allow medical staff in the respective district to work with civil society groups to do public education.

Also, the panic around the death of a fourteen-year old in Kono who was suspected of contracting the disease in Guinea has not gone away despite assurances to the contrary.

I spoke with Bala from Kabala who told me their main source of information on the outbreak is the BBC. Well, when you assume only a small percentage of the population of the country listen to BBC then you appreciate the magnitude of the problem in our hands.

When you speak to people in villages and towns bordering Guinea they tell you the information has not reached them. As far as they are concerned life must go on as usual. They are a people of the same tribe, bounded by a common ancestry and tradition, living on either side of the border. They cannot now avoid their kith and kin due to the outbreak of a disease, not even Ebola. As far as they are concerned border is a non-issue. These are issues to deal with in the broader context of the campaign.

Let me hasten to say, I do not buy into a suggestion peddled by a section of public that the border crossings should be closed. I consider it the most ridiculous suggestion I’ve heard on this issue. I understand Senegal has done just that. Let’s wait and see; they will soon realize the folly in their action.

In addition to agreeing with the position articulated by the CMO which is consistent with international best practice, it is practically impossible to close the border because we do not know the number of crossings. What’s more, people can always create one if they want to. Also, you may close the Gbalamuya and two or three other international crossing points, if you may, but you cannot stop people from crossing them. Anyway, this is not an option. Thank God, it is being roundly ignored.

These days the more I listen to the efforts of the ministry at stopping the Ebola, the jitterier I become. This is because I have a strong feeling that the approach is flawed. What’s more, the health authorities are putting the cart before the horse. They really do.

In my view the authorities should have focused more efforts on helping Guinea contain the virus. This is why I’m surprised and disappointed that almost three weeks since news filtered in about the outbreak in Guinea, not a single authority, not even our own Minister of Health has called for a meeting of Health Ministers of Mano River Union countries to take a common position on how to deal with the outbreak in Guinea.

In my view MRU countries should be proactive by helping Guinea deal with the outbreak rather than the current strategy of focusing entirely on their respective countries. I think the surest way of stemming the spread of the disease into other MRU countries is by first stopping the spread in Guinea.

This current strategy of our Ministry of Health is doomed to fail because it is not thoroughly thought out. The strategy of the Ministry of Health has been wholly inward-looking. Simply put, it is driven by self-protection. We have abandoned Guinea at our peril.

Long before now the MRU should have had a comprehensive strategy on how to deal with the situation in Guinea. This should include both technical and financial assistance. We are talking of mobilizing resources to contain the virus in Guinea.

Added to this, since Sierra Leone is arguably most at risk of catching the virus, it should have developed a strategy to complement the efforts of the Guinean authorities. I have a strong feeling that Sierra Leone should have deployed a medical team in Guinea since the outbreak was first announced. The team should among other things help their counterparts screen people travelling to Sierra Leone, so that potential carriers are isolated.

The saying goes: ‘Time and tide wait for no person’. This is a missed opportunity which might have consequences for the MRU, not least Sierra Leone.

As we continue to monitor the situation in Guinea and pray the disease does not reach Sierra Leone, the reality is very frightening. According to the BBC, there have been confirmed cases of deaths from Ebola in the capital Conakry. You will recall the outbreak was first identified in the remote South-eastern part of that country. Well, in less than two weeks the disease is now in Conakry. Scary indeed!

While, it is too early to say we are losing the fight, it is fair to say the signs are not good. This is very worrying because it means someone who should have been quarantined or isolated has slipped into Conakry.

This news should get us very worried because Conakry is closer to Freetown than it is to the South-East where the outbreak was first reported. Added to this is the volume of trade between the two cities. Hundreds of Sierra Leoneans travel to Conakry on a daily basis to do business and vice versa. To shy away from this fact – which is the case by the way – will only quicken the spread of the disease to our shores.

For now, I feel sorry for Guinea. This is a very difficult period for that sister country. I have heard of Ebola long before now, sometimes in the nineties. I first heard about Ebola outbreak in Uganda. I remember distinctly how the world was astounded following the death of a doctor from the World Health Organization who was leading the team that was treating victims.

This is the first time of learning about the outbreak in Guinea and West Africa for that matter. We should therefore be very worried, even after combating this outbreak. There should be a long term strategy in place.

So, you would imagine the difficult position Guinea is in at the moment. Firstly, Guinea is not Uganda, they do not have the experience of dealing with the disease. Also, the resources – human, financial and technical – needed to deal with the outbreak are not in plenty. They therefore need all the help they can muster. Unfortunately, they are not having it from neighbours and sisters.

They say, it’s better late than never. I think MRU countries should meet and take a common position on how to deal with the outbreak in Guinea. There are a lot of lessons to learn from outbreaks in other parts of Africa. We are not learning fast and this may haunt us if we are not careful. Hope Minister Miata is listening and stop telling us ‘There is no confirmed case of Ebola in Sierra Leone’.