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The Invisible Enemy

NOVEMBER  4, 2014 By: Dr. Adonis Abboud

Just when I thought our good old Sierra Leone could not sink any lower than the demeaning decade-long civil war that stripped us of able-bodied compatriots, along comes Ebola to show that there are depths lower than that low. Right now, no thanks to the dreaded virus, our streets and mortuaries are strewn with litany of bodies. One question as we grapple with the devastating virus is: is it just a tragedy, a misfortune or is it something much bigger? Is there an invisible enemy lurking behind this disaster now and as a warning for the future? Are there invisible enemies that we have allowed to fester which are now haunting us or still lurking in the shadows?

These questions have become very pertinent not only because of the conspiracy theories that have been making the rounds of the Social Media through the addictive Facebook, WhatsApp, etc…but also because contrary to the hopes of some, the calamity is turning out to be something that cannot just be washed away or consigned to the back burner of our history like the last cholera epidemic or even the civil war. Similarly, the destructive nature of the virus has turned it into a runaway train that is proving difficult to stop as we agonise and flail around in search of a formidable weapon against its speed and ferocity.

The twitching of structures has turned the country into a patient struggling to climb from a deathbed in the belief that its resurrection can be erroneously presented as a miracle healing. It has exposed our default health system and unmasked the deficiencies that we have for long hidden behind the paint of transformation.

With public trust and optimism in short supply one thing is clear – the biggest challenge is not even the eradication of the unwanted guest as much as what happens in post-Ebola. How do we deal with the inherent societal exposés that Ebola has laid bare? How do we tackle the invisible enemy – the unseen hand?

Having the task of management of the EBOLA crisis entrusted to the Minister of Defence was a wise move by H.E. the President. We all know that we need a Military fist to get our people to be disciplined and abide by the laws to control the situation in the safest way possible and save unnecessary loss of more lives.

Ludicrously enough, the proponents of this thinking have cleverly left out the international synergy in combating the outbreak and the huge financial outlay in assistance. What an invisible rationale. In the midst of such a devastating tragedy, politics is all that matters to some of those in authority. This is an unseen enemy that our society needs to eradicate.

The most tenacious optimists might begin to give up under the pressure of the calamities dotting the landscape. However, historic moments like this, just like the civil war that nearly consumed our nation, have one peculiarity: they are thresholds for the breaking of links that can no longer cope with the pressures of our collective life. Obviously there are lessons to be learnt in every challenge, no matter how daunting the immediate picture of such a scenario; which is why there is a need to pause and really examine our national societal ethos and governance.

Prior to the latest disaster, the prevailing view of Sierra Leone, even over a decade after our civil war, is that of a basket case in need of salvation, a land riven by hunger, poverty, victims of war and disease. This corrosive image, so destructive to trade and tourism, has been fostered by a lethal combination of our helplessness, as portrayed by the continued dependence on foreign assistance as well as internationally acclaimed pandemic corruption. It is why despite the strenuous efforts of the government in creating one of the very best enabling environments for investments, things have not been moving as fast and comprehensively as they should.

How come assistance were in a tail spin from those eager to build new structures for us but who turned a blind eye to the great issue of our tragedy and existing dilemma until they were literarily put to shame?

Anyway, the reality with us now is the Ebola epidemic and unlike some other issues, it is no longer the fear that dare not speak its name amidst the hordes of problems facing our poor Sierra Leone.

From indications it is not clear whether this crisis has reached its critical mass but as we watch and pray about how this destructive train will hit the buffers and what the bigger situation seems to be, there is a need for introspection.

There are compelling reasons to identify and imbibe the inherent lessons in the emergence of the disease, our reaction and handling of its development as well as the beneficial effects of overcoming the challenge. The most ingenious solutions to a crisis start at the lowest ebb. Just before these solutions appear as a dot on the horizon, all adventures are possible as we have encountered in the course of tackling Ebola. Therefore, as we continue the campaign to get rid of the Ebola virus, the biggest challenge today is not the eradication of the virus as much as it is the way we are going to behave in the Post EBOLA time which, if done wisely, will ensure a non-return of this diabolical Virus and other deadly ones.

For one, how did our acclaimed health system fail so badly? What could we have done and said differently? Where was leadership and decisiveness when it was most needed to guide the culturally cynical populace through a rather strange situation? With some focus on what we are going through now in the Mano River zone, we find common breeding ground for not only EBOLA but any other hygiene related virus such as typhoid, cholera, malaria, Lassa fever,  etc…..

The lack of hygiene coupled with the indiscipline of our people makes us a prey for a lot of diseases. The origin of Ebola in the suburbs of our provinces suggests the disease has a lot to do with poor sanitary condition and low standard of living. So, if the standard of living in any place is poor, we’re no more talking only of Ebola, but also of other infectious diseases. Because Ebola is the one that is causing most of the havoc now, that’s why there is the big emphasis on it.

A significant share of ill health in slums stems from poor access to sanitation and clean drinking water. Flooded areas and ditches, latrines and septic tanks are key reservoirs that perpetuate infectious disease outbreaks. The high population density found in these areas and consequent overcrowding often trigger epidemic-prone infections such as we are witnessing.

Rotary International, with the Rotary Club of Freetown in partnership with The Rotary Club of Fishers, Indiana USA, for the past 5 years has succeeded in giving over 100 villages – mostly in remote areas nationwide – the Privilege of access to clean water through their WATER IS LIFE PROJECT, becoming the only Non-Profit Humanitarian Organisation to participate in the Health and Sanitisation Campaign.

The rate of urbanisation makes it very challenging to manage. A recent paper in the New England Journal of Medicine argued that urbanisation is a “health hazard for certain vulnerable populations, and this demographic shift threatens to create a humanitarian disaster”.

Anyway, annual budgetary allocations to health are still very paltry and this has seen developments in this area worsening. For example, latest data from the Global Health observatory quotes our total expenditure on health per capita at $205 and the total expenditure on health as percentage of GDP at 15.1 percent. While official statistics, highlighting great strides sound convincing, the general consensus is that much has not been done in the health sector. Various reports by reputable international organisations can give credence to it.

Access to food, safe drinking water and health institutions is limited even in urban areas, not to talk of their virtual non-existence in the rural parts of the country. Can malnourished children with poor mental and physical development lead Sierra Leone’s future?

This country enjoyed energy and water up to the seventies. I remember we had 24/7 supply of power and water. Bumbuna, which was supposed to rescue us from a damned blackout for four decades, was the biggest failure of any contract in the history of this country. Of my forty years since I first came to Sierra Leone, I can comfortably say that only the first 8 years were the glorious ones. This country was indeed the Athens of West Africa. Parents could afford first class education for their children in our schools and Universities. Health care was at its best. Our children didn’t have to study on the light of candle or risk the dangers of kerosene lamps. Hygiene was the order of the day. Even Nigerians and Ghanaians used to boast of having their children graduate in this blessed land.

Yes, mistakes in handling the pandemic were made especially since we were aware of the scourge while it was ravaging our neighbours. Guinea’s first case occurred in December 2013. However, it is only in March that it was confirmed as an EBOLA case. April should have been the time where precautions to stop the Virus from sneaking through our porous borders should have been put in place. We only started moving two months later.

As H.E. President Koroma said it on more than one occasion, “EBOLA is new to us, we don’t know much about this deadly virus”. I personally shivered when I heard the leader of our Nation narrating our ordeals with so much strains and emotions, which is difficult to hide even in the highest office of this Land.

We went through 13 years of civil unrest, what did we learn from those years but more divisive communities and more negative attitudes.

The west went through much bigger conflicts and devastations such as the black plague etc. These experiences were hard lessons which made them spring to democratic systems, flourished development and whatever we admire them for today. We must therefore rejuvenate ethical, social and cultural values to guide our sustenance as a people if we are concerned for the future.

Eternal vigilance should be the watchword as the country needs to be on the alert and ready to act in the case of any other outbreak, while health workers’ training must be geared towards their understanding of new challenges and how to adhere strictly to protocols and respond well. They must also imbibe the culture of regular hand-washing and the use of gloves in the course of their duty.

The outcome, and subsequent identification of naturally immune individuals, could help shape public health efforts to contain the disease, as well as allowing for accurate estimates for the likely spread of Ebola and other devastating diseases..

While I must emphasise the need for creating greater awareness, if the war against Ebola is to be won completely, there are several areas of our towns, cities and villages where the environment is just not suitable. In such places, something needs to be done – whether private or government.

Apart from putting in place a permanent monitoring and sanitation team, the government should ensure that it does not disband all the structures on the ground now courtesy of international efforts, but rather hone their effectiveness and efficiency as well as do more to consolidate the efforts.

Epidemiological data and operational information about outbreaks is dynamic and changes rapidly. The fight against Ebola and future outbreaks must always be backed by essential political will and support at the highest level of governance as soon as hints of such worrisome reports emerge. Neither should we forget the need for social and political education as we cannot continue in this blind race of destroying values because of greed, tribalism, selfishness and mistrust, which has polarised our governance and society.

As we march on after this trying time, the government needs to do all within its powers to reassure the citizens, helping them to get back their lives, strengthening the nation’s capabilities to prevent the disease and giving support to businesses affected by the outbreak.

Post EBOLA era must be one of drastic changes in vital elements which affect our daily life and protect us from the Invisible Enemies. Prioritise our actions as follows:

1- Invest generously in the modernisation of our Health Care System

2- Ensure hygiene is strictly observed in our hospitals, households, college campuses, schools, markets, streets, and every corner of our cities.

3- Educate our school going children on the benefits of hygiene while highlighting the damage that can affect their livelihood if certain precautions are not observed.

4- Impose a fine on any household, shop, industry, pedestrians, commercial and private vehicles found contravening the minimum requirements of keeping their premises clean and free from bacteria.

Given all these, it is obvious that what Ebola has taught us is that if we do not change the focus of our development and transformation, we might discover too late that, what we were looking at in the horizon, is a perfect storm brewing and ready to burst open in full force.

If it does, the catastrophe is likely to consume us even more than the civil war.

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