July 15, 2015 By Ahmed Sahid Nasralla (De Monk)
The ravaging embers of the Ebola Virus Disease may be quietening down but the biggest and most difficult challenge now for Sierra Leone is reaching that ultimate zero target and staying there forever.
When Liberia was declared Ebola free on May 9th 2015 after about 14 months battling with the dreaded disease, there was optimism that Sierra Leone would soon follow suit especially as the country continued to record single digits for weeks. But such optimism was soon qualified with the word ‘cautious’ added before it by the CEO of the country’s National Ebola Response Center (NERC), Rtd. Major Palo Conteh, when he said: “We’re now on a bumpy ride to zero”.
At some point the ride was less bumpy and the road ahead looked smooth. So the government, with some pressure from some sections of society, announced a relaxation of some of the Public Health Emergency restrictions. The atmosphere changed almost completely following that pronouncement, with things getting back to normal again. But it actually seems we are getting back to where we started- the state of denial.
In the minds of the majority of Sierra Leoneans across the country Ebola is gone, and they are getting back to their old ways. People generally are behaving as if it is all over, when actually it is not. Psychologically people are tired and want to move on; and they can only wish Ebola away in these latter but critical days. Some are even suggesting that government lift the Public Emergency entirely and let’s treat Ebola as just another disease we’ve been accustomed to- such as malaria for example; making reference to Guinea, where they claim life goes on as normal despite the country recording high figures of new confirmed cases.
The Veronica buckets are disappearing, the hand-washing is not a hygiene habit in most homes and public places anymore, touching is common place again, clubbing and social gatherings have suddenly returned with little or no regard for Ebola precautions.
Organisations and agencies that have been robust in the fight against the disease have taken the foot off the pedal. Even UNMEER is packing to go, and other agencies are going back to their core functions, abandoning their coordinated efforts against Ebola, as if the disease is gone already.
Yet all of a sudden the cases have erupted again; first in the Northern towns of Port Loko and Kambia, the latter sharing border with Guinea, and then the Western Area has also joined the bumpy band wagon. As recently as June 25th 2015, three doctors and 28 nurses in the Princess Christian Maternity Hospital in Freetown were quarantined following the case of a mother who tested positive for Ebola after giving birth. The mother actually gave birth at home and was only brought to the hospital after persistent bleeding. Worse, we begin to hear about run-away quarantine cases.
And Liberia is now recording new cases all over again two months after it was declared Ebola free by the World Health Organisation, with the chain of transmission of its three recent new cases still only speculations.
Apparently, the guard has been let down.
Since the epidemic broke out in December 2013 in south of Guinea, there have been 27,443 infections in the three-affected countries, with about 11,207 deaths. Of the 872 health workers said to be infected, 507 reportedly died of the disease. These statistics are even said to be largely under-recorded.
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Sierra Leone alone has reported more than 3,900 Ebola deaths.
Meanwhile, while all the energy seems to have been diverted to post-Ebola recovery efforts we must not lose sight of the fact that the real recovery process starts with getting to zero and staying there. No matter how good the recovery plan is, it is meaningless effort if we don’t get to zero. In fact, the recent case of Liberia has clearly shown that no one of the three countries can get to zero and feel safe from Ebola.
The Government of Sierra Leone, through NERC, has done right to extend ‘Operation Push’ so we can continue pushing until the country gets to zero and beyond. Equally, it has extended the curfew in the two districts of Port Loko and Kambia to consolidate gains and confine the disease. Nevertheless, the actual problem may lie in the Western Area (both urban and rural) with an actively mobile population, and where much of the denial is beginning to show now that we are on the road to zero.
Re-strengthening the containment structures at community level and ensuring that areas that have gone beyond 42 days Ebola-free remain safe is crucial to defeating this devastating disease. And the messaging too must change. The current message has become monotonous to the ears of the public and it is not making a difference anymore. Let us rephrase the Ebola conversation and let it sound new to the people.
Indeed this ride is getting real bumpy.