Ebola: Stay at Home Day...

Anyone who has been in Freetown will know that empty streets like this are highly unusual. I am not sure if I have ever seen the streets this empty. This past Monday, the 4th of August was declared a "Stay at Home Day" by the President of Sierra Leone. At the time the President made the announcement, no one really knew what he meant. So what did it mean?

Pray. Reflect. Educate.

Basically, almost every citizen in Sierra Leone stayed indoors that day or at least on their own compound. Meanwhile health workers and volunteers went from compound to compound sensitizing people. Most importantly, I think people started realizing what this virus is and that they need to report sick people to the hospital. And hopefully, while people were in their own homes, maybe, just maybe, for 24 hours, the Ebola virus was not being spread as actively. 

I think overall the day was a success. I think it showed that the citizens of Sierra Leone are serious about this and that they are ready to obey Presidential orders. I believe that many people were educated that day and I hope we start seeing some positive impact of that. Things need to start changing. Let's hope that this "Stay at Home Day" brought about some behavioral change!

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. 

Ebola: news no one wanted to hear...

The news that no one in Sierra Leone wanted to hear was announced on Tuesday the 29th of July 2014. Dr. Khan, leading expert in viral hemorrhagic fevers, passed away in the MSF treatment centre.

"It is with heavy heart that the Ministry of Health and Sanitations informs the general public that Sierra Leone’s only virologist Dr. Shiekh Umarr Khan passed away this afternoon at the treatment Center in Kailahun. His body has been conveyed at the Lassa Fever Mortuary in Kenema and plans are underway for his befitting burial on Thursday." 

Although Dr. Khan lost his own life to Ebola, he saved at least a hundred others from this dreadful disease. He took a risk to help his people, his country and lost his life to the very disease he was saving other people from. Dr. Khan is a hero in the eyes of Sierra Leoneans today. He literally put his life on the line for fellow Sierra Leoneans and many people are grateful to him.

Dr. Khan's death is a tragedy. As expert in viral haemorrhagic fevers and leader of the Kenema treatment centre, his death leaves a huge gap in the health care system, especially in this fight against Ebola. Who will step into his shoes?

As devastating as this news is to the entire country, I pray that it stirs people into action. I pray that doctors and nurses will (continue to) work in the front lines to combat this disease - I pray for courage, stamina and protection. I hope that the people of Sierra Leone, Liberia and Guinea will realize that Ebola is REAL. It is not the government injecting people and killing them, it is not a curse, it is not something the white man is making up to harvest organs, it is not a political game. Ebola is REAL. It is a disease that spreads through contact with bodily fluids from an infected person, which means it is also a disease that can be prevented if that contact is avoided. People need to realize that if their family member is suspected to have Ebola it is in the best interest of the patient, the family and the community for that person to be isolated. It is the only way to break the chain of transmission. People need to realize that treatment centers are not death chambers - they are places that optimize the chance of survival. There are survivors. Without going to a treatment centre, the chance of survival at home is close to zero, but by going to a treatment centre, especially going early, the chance of survival is higher (overall death rate in three countries is currently about 60%). There are so many things that the general public need to know. 

I pray that through the tragic death of Dr. Khan there will be a massive turnaround in behavior and attitudes and that necessary action will be taken on all fronts to end the Ebola epidemic. I realize that this will take some time but let's continue fighting, in honor of Dr. Kahn.

Ebola continues in Sierra Leone...

Since writing about Ebola two months ago, the number of confirmed cases continues to increase in Sierra Leone. According to today's report there are a total of 458 confirmed cases, most of which are in Kailahun and Kenema. However, seven other districts have had confirmed cases as well, three of these districts had their first cases in the past week. Unfortunately travel within the country and in some cases lack of containment of suspected or confirmed cases has led to the spread of Ebola. In many cases, people’s beliefs and behaviors have contributed to the ongoing transmission of the disease. I will write more about this next time.

This past week has been particularly challenging. The news of three of the nurses at Kenema government hospital, the site of one of the Ebola treatment centers, dying of Ebola early this week was a shock to many. It also led to health workers going on strike and the treatment centre being depleted of staff. Also, the news of Dr. Sheik Umar Kahn, head of the Lassa Fever Unit and current Ebola treatment centre, testing positive on Tuesday was also a big blow. Dr. Kahn, a 39 year old Sierra Leonean doctor, is one of the world's leading clinical experts in viral haemorrhagic diseases, so to hear that he had been infected with Ebola was a big concern. He has treated over 100 patients in the treatment centre, spending long hours trying to save their lives. Thankfully the news is that he is recovering in the treatment centre in Kailahun, run by MSF. Let’s hope he pulls through and that his story can be a testimony to the Sierra Leoneans that this disease is real and that treatment early on can save lives. Maybe this will urge people who are sick to seek care at nearby hospitals rather than hiding in their homes.

Another big concern for Freetown was when relatives forcefully removed a lady in her thirties, suspected of Ebola, from an isolation area in a government hospital on Wednesday afternoon. Very quickly health facilities were on the alert to look out for this patient and officers were trying to track her down. On Thursday morning her result came back positive for Ebola and at this stage it was even more of a concern that she was somewhere in the community. On Saturday morning she returned to her residence and agreed to go to the treatment centre with her parents. Meanwhile, her home was under quarantine with some of the contacts inside. Although she has been found, there is obvious concern that she was in the community for some time (60 hours?) and likely transmitted the disease to others. Transmission is through contact with bodily fluids, so hopefully very few people came in such close contact with her. With an incubation period of 2-21 days (average of 5-7), it’s probably a matter of days before we know what the impact is of her escape.

While I am writing this I am watching SLBC news and over the past hour I have seen multiple news stories about Ebola. One story featured an event held today: "Pharmacists, Pharmacy Technicians and Pharmacy Owners sensitized on Ebola". It was said that 80% of sick people seek pharmacies first for healthcare (rather than going to a clinic or hospital) and so pharmacy staff is advised to take precautions and refer any suspected cases to the nearest hospital so that the patient can be isolated to break the chain of transmission. Unfortunately in Sierra Leone, many pharmacies are like little clinics where patients can opt to be treated in a back room with drips and injections. This practice is strongly discouraged, especially with the presence of Ebola in the country. According to the report, two pharmacy workers have already contracted the disease. Another news item was about a sensitization day for youth in Kono, a district which to date has not had any cases. It is good to see that sensitization is taking place – this is essential!

So, the story continues. I am wondering if we have already reached the climax, or if it is still to come. More soon…

Position Available: (Paediatric) Nurse Educator...

Welbodi Partnership is recruiting a nurse educator, with significant experience in maternal and child health, to support the well-established nurses’ training office at the Ola During Children’s Hospital (ODCH) in Freetown, Sierra Leone. In addition, the (paediatric) nurse educator will help establish a nurse/midwife training office at the neighboring Princess Christian Maternity Hospital (PCMH) as well as support the newly established Paediatric Nurse Specialist training at the College of Medicine and Allied Health Sciences (COMAHS).

This rewarding position offers a unique opportunity to be involved in the development of human and institutional capacity, crucial for the rebuilding of the health system in Sierra Leone, with a focus in improving maternal, neonatal and child health.

The successful candidate will be employed and managed by the Welbodi Partnership, a UK registered charity, based at the Ola During Children’s Hospital since 2009. Welbodi Partnership works with the Ministry of Health and Sanitation (MOHS) to support the development of ODCH and PCMH with the aim to improve maternal, neonatal and child health outcomes in Sierra Leone.

PLEASE GO TO THE ADVERTISEMENT ON THE WELBODI PARTNERSHIP BLOG FOR MORE DETAILS: 

http://www.welbodipartnership.blogspot.com/2014/06/position-available-paediatric-nurse_28.html

Please distribute this notice widely to those who might be interested in this great opportunity to help us improve maternal and neonatal healthcare in Sierra Leone

Efforts to fight Ebola in Sierra Leone...

It was too good to be true that the Ebola outbreak in neighboring countries, Guinea and Liberia, would be contained and stay out of Sierra Leone.  On Monday, the 26th of May, Ebola was confirmed in Sierra Leone, in Kailahun district, a few miles from the Guinea border, quite near the epicenter of the outbreak in Guinea. This is a serious concern. 

The Ministry of Health and Sanitation's Ebola Task Force has been meeting on a daily basis with the aim of turning the nation's Ebola preparedness plan into a response plan. The task force created sub-committees to focus on elements key to outbreak response such as: laboratory, surveillance, coordination, logistics, case management and communication. The committees report to the task force and decisions are made. 

Welbodi Partnership, as well as some other key NGO's such as King's Sierra Leone Partners, Emergency Surgical Centre and MSF and other agencies, joined the case management committee in order to support the Ministry in fighting this battle. Yesterday we were in non-stop meetings from 1pm - 6pm to finalize plans. And this is just the beginning. Next comes the ongoing efforts to follow through with plans. And, for Welbodi Partnership, we will continue supporting the Children's and Maternity Hospitals in establishing/running their isolation units and providing logistical support to the hospitals' Ebola Coordinators as well as maintain the link between the hospitals and the Ministry. We will also be involved with training of healthcare staff to ensure that they are well informed about the preventive measures they need to take.  

Of course, with an outbreak like this also comes a lot of unnecessary drama, especially a lot of mis-information. The Ministry is, rightfully so, concerned with some of the information that has been published on the internet/social media. So, for the record, all statistics reported here will be taken directly from the information released by Sierra Leone's Ministry of Health and Sanitation. As of the 30th of May there were 14 confirmed cases, all of which were in Kailahun district. There are no cases anywhere else in the country. There were a few suspected cases in Freetown, but they were all NEGATIVE. Let's hope that this disease will be contained and not spread further than Kailahun district. 

For information directly from the Ministry of Health and Sanitation you can go to their facebook page: 

https://www.facebook.com/pages/Ministry-of-Health-and-Sanitation-Sierra-Leone/281064805403702

Position available: Project Manager - Maternal and Neonatal Health Project

Welbodi Partnership is recruiting a Project Manager for its new Maternal and Neonatal Health Project in Freetown, Sierra Leone. This is an exciting opportunity to make a difference in healthcare in West Africa.

Here's a quick preview:

Welbodi Partnership’s maternal and neonatal health project comprises two complementary interventions: engagement with women in the urban communities of the Western Area and health system strengthening initiatives to improve the quality and accessibility of essential obstetric and neonatal healthcare services at PCMH. 

The application deadline is June 15th, 2014.

If you, are someone you know is interested, please see the following link for details: 
http://welbodipartnership.blogspot.com/2014/05/position-available-project-manager-for.html 

Position Available: Consultant Paediatrician - Head of Training - Ola During Children's Hospital

The Ministry of Health and Sanitation in Sierra Leone is recruiting for an available position of a Consultant Paediatrician to serve as Head of Training at the Ola During Children’s Hospital in Freetown, Sierra Leone.

Position Available: ConsultantPaediatrician – Head of Training

Location: Ola During Children’s Hospital (ODCH), Freetown, Sierra Leone

Reports to: Medical Superintendent, Ola During Children’s Hospital

Supervises: Medical Officers, Residents, House officers, and Medical Students            

Contract length: 12 months, with possibility of extension subject to funding availability and satisfactory performance

Start Date: As soon as possible

Remuneration: Competitive, to be discussed with the selected candidate

Application deadline: 4^th June 2014

The Ola During Children’s Hospital is the national children’s hospital located in the eastern part of Freetown with approximately 10,000 admissions per year. The hospital provides medical care for neonates and children from the Western Area but also serves as the only tertiary referral centre for paediatrics for the country. The hospital was granted temporary accreditation by the West African College of Physicians in November 2013. As a Consultant Paediatrician – Head of Training you would have a direct and significant impact on the quality of care provided at the Children’s Hospital and play a crucial role in the development of Sierra Leone’s first ever postgraduate training programme, producing the country’s future leaders in child health.

Please see the full terms of reference and application details here:

Terms of Reference

Application Form 

Please distribute this notice widely to those who might be interested in this great opportunity to help improve child healthcare in Sierra Leone.

Applications

Application deadline: 4^th June 2014

Applicants are welcomed from all nationalities, including Sierra Leoneans at home or in the diaspora.

In accordance with equality and diversity policy and child protection policies, successful candidates for this position will require a Disclosure and Barring (DBS) check, or national equivalent. We will comply fully with the DBS Code of Practice and undertake to treat all applicants for positions fairly.

Please complete and email the application form, accompanied by a CV to Dr. Sandra Lako, email: jobs@welbodipartnership.org 

CVs and cover letters will not be accepted for this position without a duly completed application form.

Only those applicants shortlisted for an interview will be notified.