Tuesday, August 05, 2014

Ebola: State of Emergency...

On the 30th of July His Excellency President Ernest Bai Koroma declared a State of Emergency in Sierra Leone.

"The disease is beyond the scope of any one country, or community to defeat. Its social, economic, psychological and security implications require scaling up measures at international, national, inter-agency and community levels. Extra-ordinary challenges require extra-ordinary measures. The Ebola Virus Disease (EVD) poses an extra-ordinary challenge to our nation. Consequently, and in line with the Constitution of Sierra Leone Act Number 6 of 1991, I hereby proclaim a State of Public Emergency to enable us take a more robust approach to deal with the Ebola outbreak."

So, there we are. The President has spoken. Action needs to take place. Fast. 

We've all read the stories and seen the pictures. People are dying. People are hiding. Ebola is spreading. Health workers are affected. Dr. Khan passed away. Health workers feel unprotected. Travel causes spread.  Flights are suspended. American Ebola patients are evacuated. Regular patients are not showing up to hospitals. A stay at home day. More flights suspended. Expatriates pulling out. New cases. New districts. Some survivors. More new cases.

So, what needs to be done? 

Contact tracing, sensitization, protection of staff. I would say those are the three main areas that Sierra Leone needs to tackle quickly (amongst a number of other areas of course). Without contact tracing, transmission will continue. Without sensitization, sick people will not come forward and they will continue to transmit the disease and die in the communities. Without protection, health workers will not carry out their duties. 

More trained contact tracers. More vehicles. Social mobilization. Radio messages. Interviews with survivors. Famous people speaking to their peers. More protective equipment. Training on infection control. Implementation of universal precautions. Allowances. Supervision. Positive stories.

It sounds straightforward but it is tough. It requires a massive influx of expertise, manpower and resources. It demands changes in attitudes of health workers and in behavior of the general public. It relies on excellent communication between stakeholders and strict measures to be put in place by government. All of this needs to be accomplished in an already fragile health care system and in a society in which many people are living day by day trying to make ends meet and a culture in which family bonds are tight and caring for your sick relative at home is the norm. It’s a challenge but I think it is possible.

WHO says "this outbreak is spreading faster than efforts to control it". Let's pray that in the next few days the efforts to control this outbreak are multiplied and speed up ten times more than the disease itself spreads and we start making some headway. It is possible. It has to be. There is no other option. 

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