February 27, 2014 By Ahmed Sahid Nasralla (De Monk)
Unlike Nigeria, Ghana may have not registered any Ebola case since the outbreak hit the Mano River Union (MRU) basin of West Africa, but in the event the Ebola Virus Disease (EVD) attacks the country the first volunteer to help in the fight is Sierra Leone’s Minister of Defence, Rtd. Major Alfred Palo Conteh.
“We hope it doesn’t happen in Ghana. But if Ghana gets Ebola, I’ll be the first volunteer to go there and help,” said Rtd. Maj. Conteh, who is also the Commander-in-Chief in the fight against Ebola in Sierra Leone.
This shows how grateful Sierra Leone is to Ghana as a result of the latter’s contribution to eradicate Ebola out of the small West African country. Ghana is an integral contingent of the West African Health Association (WAHO) medical teams deployed in the three affected countries of Liberia, Guinea and Sierra Leone as part of a regional initiative in response to the Ebola outbreak.
Ghana also donated a plane load of food stuffs (chocolate, milk, rice, etc) which, according to the Ministry of Health and Sanitation (MoHS), helped greatly in the recovery of many Ebola patients by building their immune systems stronger to shake off the virus.
Now a medical team from the Ghana Ministry of Health has been here since 25th February, 2015, to review the Ghanaian response in Sierra Leone and to learn some of the things the country did right (and wrong) to get where it is in the fight against Ebola.
The team comprises designated officials for potential Ebola treatment centers in Ghana and TV crew, headed by Dr. Fred Adomako-Boateng (Deputy Director, Clinical Care, Public Health Physician, Head of Case Management Team and Head of Rapid Response) and Dr. Ofori Badu (Emergency Physician Specialist in charge of ETU in Tema, Ghana).
In the company of the Ghana High Commissioner to Sierra Leone, the team visited NERC (the National Ebola Response Center), UNMEER, the 117 Emergency Call Center, the Command and Control center, decontamination center, the Situation Room, some holding and treatment centers including PTS 1 and 2, the ETC at Hastings and Kerry Town and shared ideas and learned at first hand the organizational structure of Ebola management in Sierra Leone.
At NERC, headed by Rtd Maj Conteh as CEO, the Ghanaian team wanted to know how Sierra Leone managed to get this far in the fight against Ebola.
Sierra Leone used to record up to 400 cases per day but now the figures are fluctuating between 2 and 15, and some districts have even gone long past 42 days without any confirmed case.
“To understand where we are today in the fight against Ebola we need to look back from the beginning,” said Rtd. Maj. Conteh. “We had only one laboratory in the Eastern part of the country, which was not even for Ebola but for Lassa Fever. We had no ambulance. There was virtually no infrastructure.”
He said the country’s health system was weak and they were caught off guard.
“Our government’s focus when we came to power in 2007 was on building road infrastructure, electricity and water. Not much attention was paid to the health sector,” he said.
However, today the country now boasts about 100 ambulances, 100 functional ETC beds, 600 holding centers, 14 laboratories- 6 of them in the Western Area.
“We are right on top of the situation now. We now have the resources to fight and we are on a bumpy ride to zero. Yes we’re winning battles, but the war is not over yet,” said Rtd. Major Conteh.
On 25th May 2014 Sierra Leone registered its first Ebola confirmed case in Kpondu village, Kailahun District, in Eastern Sierra Leone. Its travel history was traced to Guinea whose borders with Sierra Leone are walk-able distances. This single confirmed case has led to the deaths of about 3000 Sierra Leoneans and over 8,000 infected by the dreaded disease.
“To us one case is an epidemic,” reiterated the NERC boss. “The fight is still on, and so we are appealing to our partners in this fight not to withdraw their volunteers from the ground yet; instead replace them as the case may be.”
According to the NERC boss, the MRU President has set a target of 60 days, from 15th February, for Sierra Leone to get to zero cases across the country.
But the biggest challenge is the human behavior, lamented Rtd. Maj. Conteh.
“How do we get our people to stop traditional practices which spread the disease easily? That is the challenge we face now,” he said.
To prevent or control an outbreak in Ghana, the NERC boss advised the team to strengthen their health system and to use a military approach.
“Zero in on the disease. Quarantine the infected area. And use a military approach to curb it,” he said.
In addition, UNMEER Crisis Manager, Bintou Keita, highlighted to the delegation four key points in stopping and treating Ebola.
“Active surveillance and contact tracing, ensuring that samples of suspected cases are brought forward from the laboratories quickly enough for isolation to take place, safe and dignified burials and community awareness raising and sensitization. This is part of the preparedness for Ebola,” said Bintou.
She said social mobilization and community engagement should take place at all levels not just from top to bottom or bottom to top.
“There must be sustained interpersonal interaction with the population at all levels,” continued Bintou.
The UNMEER head also highlighted the challenge of human behavior.
“You can have all the resources and the know-how but if the people don’t change their behavior you will never win the fight against Ebola,” she emphasized.
“So you have to continue educating the population while you strengthen your health systems; not just for Ebola but for other communicable diseases as well.”
There are about 2000 Ebola survivors and many more orphans in Sierra Leone, and the Ghanaian team wanted to know about post Ebola plans for these groups.
The deputy Minister of MoHS II, Madina Rahman, revealed that the World Health Organisation (WHO) is looking into the establishment of survivors’ clinics in every district in the country to deal with post-Ebola related health problems affecting survivors. One such clinic, she said, is already operating at the 34 Military Hospital at Wilberforce, Freetown.
Most Ebola survivors are now being diagnosed with mental problems, visual and auditory impairments, insomnia, anemia, and even malaria.
“We are working to ensure that Ebola survivors don’t have to pay for medical services for at least a year,” said madam Rahman.
In relation to children orphaned from Ebola, the deputy health minister said there are challenges of care, schooling and psycho-social counseling but disclosed that the Ministry of Social Welfare, Gender and Children’s Affairs is working to have a comprehensive registry of all such cases for post-Ebola interventions.
“We have a lot of things we have to put in place in terms of post-Ebola challenges and it takes time. We have to draw from the experiences of experts and other nations that have gone through similar scenarios,” said madam Rahman.
About three months ago, it was madam Rahman who received the Ghanaian contingent of WAHO at the Lungi International Airport.
“They (Ghanaian team) fitted in firmly and blended with the operations smoothly,” she said. “I promised them I would ensure they return after their assignment in one piece. I believe I have fulfilled my promise.”
She added: “You’ve helped us, but in the process you’re also helping yourselves. You’re prepared now for any eventuality. Ebola is all about preparedness.”
Credit: Development and Economic Journalists Association-Sierra Leone (DEJA-SL).