“The hit of the Ebola Virus Disease also expressed the limitations of our medical system”

A word from Denis, Ngotho Lansana, Project Manager from Network Movement for Justice and Development in Kenema, Sierra Leone.

Do you see first signs of improvement of the situation? Are the rates of infection decreasing in Kenema?

If anything, credit is due all international and local bodies, including Sierra Leoneans themselves for their exquisite roles in the fight to curb the fearsome Ebola dread. This development has subsequently engendered the easing of the people’s suffering and overhead burdens incurred across the country.

This picture is well replicated in Kenema district which recently enjoyed a twenty-three consecutive day long zero infection. This state was, however, marred by a one-off case in which the victim came from Freetown. Since then, there has been another period of relief, which was running into the fourth week-gradually heading for the 42 days stipulated by W.H.O. to see us an Ebola – free district when from the blues, there has been another slight stoke in the infection rate within the township of Kenema, numbering three The District Medical Officer (DMO), who doubles as co-ordinator for the Ebola Response Team representing the Ministry of Health and Sanitation on these note made the following remarks at a recent routine Ebola briefing “We would all attest that we have been very close to becoming an Ebola – free district, with only twenty one days left to reach our destination. But with the very recent three incidents, it is regrettable to say that we are begging to count all over again".

What about the stigmatization? Is this still one of the pressing problems and do you think that the awareness raising activities have an impact?

The problem of stigmatization which used to be experienced by Ebola survivals has dramatically dissipated. Counselling bodies/structures, including a mix of religious and youth leaders, teachers and so on, have been established in the different NMJD operational chiefdoms; especially Ebola hot-spots. These have also been instrumental in maintaining sanity and peaceful co-existence among the populations. They convene community meetings, where they counsel people to embrace their Ebola survival brothers and sisters. The same is replicated in the Mosques and Churches. This drive has had a great impact on the people. A typical case of stigmatization is express in the words of one survival Monjama Kamara age 19 at Peri-Fefewabu village in Gaura chiefdom. “Initially, after our discharge from the hospital as Ebola survivals, four of us, we were completely shunned by our own very friends, relatives and neigh neighbours. They never had confidence in our state of health then. Rather, we were seen as potential vectors. There was gossip here and there” she revealed.

Consistently following up development, our organization, NMJD, which is concerned with, and focused on seeking the welfare of fellow Sierra Leoneans noted the case of discrimination and stigmatization to be true and overwhelmingly, at least for the first two to three months of our intervention.

Responding to the situation, NMJD, therefore entered into operation communities and established community counselling teams in contact with local authorities, in order to help alleviate the psycho-social overhead problems. In recognition of this intervention another survival Fatmata Williams of Komende Luyama Lower Bambara Chiefdom gave the following compliments:
“Our situation had become desperate and deplorable, almost at breaking point, until NMJD thought it wise to come to our aid. Today, we have a sigh of relief."

Also apart from counselling teams established, other networks of pro-active Ebola related health structures have been established in operational communities, including social mobilization teams, neighbourhood watch groups/ contact tracing units. In that regard, public education and sensitization have been expedited. For instance, community health volunteers have been educating/sensitizing populations in target communities on the use and importance of regular hand-washing, abstinence form washing dead bodies, irrespective of the intimacy; especially at the peak and thick of a contagion like Ebola, as well as the benefit of discouraging public gatherings of any nature.

Subsequently, the message tend to be filtering down, as community people have, wholesale, adopted the ‘good practices’, with noticeable changes in behaviour and attitudes. This has apparently, largely, contributed to curbing the spread of the dreaded disease. All is aided by stringent measures put in place, in the form of by-laws, by local authorities down to the chiefdoms, sections and wards.

In the same vein, burial teams have been organized at chiefdom level, trained, and provided with Personal Protective Equipments to undertake safe community burial and are doing well. Community members, too, have gradually recognized the need and importance dissociating from burying their loved ones with implicit understanding. These developments have been very impressive.

One female adult Ebola victim who lost three of her family members to the disease made the following observation: “When the disease initially struck, fellow Sierra Leoneans who are particularly drunk took it as a joke and means of expressing chronic political grudges they ever harboured against each other. Some said it was a ploy of the government to attract fund from the international community and donors, while others cling to the rumour, again that, it was a western scheme intended to reduce Africa’s population. Whichever opinion hold, these conflicting views gave cause for the initially high denial and therefore, high infection rate. But with the setting up of these community education structures, with some members drawn from the very from the very target communities, doubts about the reality of the disease is no more. We are, on this note, very grateful to NMJD for its intervention, though rather very late. We all have joined the crusade, to Ebola out of community and the country as a whole”

Certainly, since Ebola has been a very strange phenomenon and the illiteracy level high, coupled with bad politics, denial rate about the existence of the epidemic has been very alarming. The majority had to dwell more on rumour, until this late, when it actually either touched themselves directly, or their close ones.

Strengthening surveillance through neighbourhood watch groups has also proved to be very effective. Vigilante youth structures set up at community level have been very robust in checking the movement of people in and out of their respective communities. This restriction has certainly helped a long way to breaking the chain of transmission and stemming the spread.

Could you describe the daily life in Kenema?

The daily life situation is gradually gaining normalcy-with the lifting of the moratorium on all internal travels, coinciding with the recent reduction in the cost of fuel, situation happens to be stabilizing. At least transport cost has normalized, with businesses being revived gradually. People now even converge at local trade fairs, commonly known as ‘Loma’. A business woman shared her view on the latest development: “It is so relieving that the travel ban has been lifted. We solely rely on our petty business to cater for the upkeep of our homes, pay the fees of our children in schools and attended to other needs. Having permanently kept us in our homes for this long certainly has had a serious negative effect on our source of livelihood. Thank God, it is over!”

However, to date, schools and other learning institutions remain closed. Only that the government recently pronounced the re-opening of schools in March, 2015. Meanwhile, modalities are being put in place to make the schools once more conducive with every Ebola testing equipment installed. Teachers, too, are being trained to use the instruments. Additionally, school curriculums will have to include aspects of Ebola virus disease and other preventive disease.

Expressing her gratitude for the pronouncement regarding the re-opening of schools, a concerned parent had this to say: “I think I can now breathe a sigh of relief for the fact that government has made mention of schools’ re-opening for our children, especially the girls, who stand to be more vulnerable. In fact, most of them are already, unfortunately pregnant – another overhead on us parents. The majority of them have not even been touching a leaf in their books.”

What should be the next steps?

It is not to emphasise that the outbreak of the Ebola Virus Disease (EVD) has systematically devastated every fabric of the Sierra Leone society. Besides the heavy death toll, it left behind orphans, widows and widowers, an alarming incident of teenage pregnancy tampered with agricultural calendar which might in turn lead to acute shortage of food stuffs in the near future.

Moreover, it seriously affected individual and national economies, the human resource in the case of the deceased doctors, nurses and other health personnel. Even most survivals of the virus have been left with various forms of impairment, both physical and/or psycho-social. Host of the survivals are suffering from various post Ebola syndromes/ complications ranging from persistent headache, malnutrition, drowsiness, menstrual complications and pain for women, psychological trauma, partial visual impairment and the like. NMJD therefore offered support to some of the survivors with body building and energy food non- food items, to resuscitate their lives see in attachment comments by some of the beneficiaries upon receipt of the items and a case study on one of the survivals.
Given the grim picture left in the aftermath of the Ebola crisis the following are recommended for the attention of the international community.

Both Survivors and survivals from the disease apparently remain to be liabilities, as most of them lost the bread winners in their families. Support towards their survival in this aftermath should be prioritized.

Ebola survivals, most of who incurred other impairments physical or otherwise, during the course of their illness also need urgent attention and support towards their health statuses. They even to organise as a body, empowered enough to be able to demand for their health rights.
There is also need to establish social mobilization groups at chiefdom level. At the same time, neighbourhood watch groups to intensify local- rural and even urban tracing activities. More over to avoid complacency in the communities.

Typically, Sierra Leone is an agricultural country, and for this farming season, the disease interferes with the schedule in terms of time and farming inputs. The international community and related donors should, therefore, step in to salvage the situation from going bad.
The hit of the Ebola Virus Disease also expressed the limitations of our medical system in the country. There is need to also address this very serious odd.

Published: 03. February 2015

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