Tuesday, July 22, 2014

Sierra Leone Should Recalibrate Ebola Response

Correct Ebola Protective Gear
The sheer incompetence with which the Ebola outbreak has been handled in Sierra Leone is mind boggling. When government first made the fateful decision to move Ebola patients from the relatively isolated areas of Kailahun district to the populated Eastern capital of Kenema,  I did in one of my earlier postings question the wisdom of such a move. For a deadly virus like Ebola,  isolation simply does not simply mean building isolated wards in populated areas. It actually means confining such outbreaks in remote locations, away from population centers.

Unfortunately,  the response to the Ebola epidemic in Sierra Leone at the official level been mired in mudslinging and political infighting.

Sierra Leone Ebola Worker
Poor Protective Gear
Instead of having a Presidential task force comprised of district leaders,  the President's circle of trusted advisers and leading infectious disease specialists working together to stem the outbreak, the response has been characterized by political grandstanding,  accusations of disrespect and incompetence, and the pursuit of personal vendettas.
Freetown Based Miatta Kargbo

The open war of words between the Health Minister Miatta Kargbo and the Special Executive Assistant to the President Sylvia Blyden,  fueled by alarmist stories from her Awareness Times paper and social media has painted a picture of a government that was unprepared to deal with the Ebola incidence,  in spite of the fact that the virus had been waging it's deadly rampage in the neighboring countries of Guinea and Liberia for some time,  and it was only a matter of when before it surfaced in Sierra Leone,  given the geographical proximity to the areas of infestation.

This mixed message from those close to the President has been one of the main problems in the country's response,  as all efforts to educate the mostly illiterate people of the affected areas has been drowned out by the belief of the people that the government does not care for them and that the health officials do not know what they are doing,  a view buttressed by the daily accusations of ministerial incompetence by none other than the Special Executive Assistant herself,  who has seen this tragedy as a source of political capital and intends to milk it for all that it's worth.

The Kailahun district, where the virus initially surfaced is in the Eastern part of Sierra Leone, far removed from the country's capital. Chronically bad roads mean that it is also relatively geographically isolated.  Years of civil war also cut off most of the district from the rest of the country for extended periods. During the war Health care infrastructure and systems in the area were mostly destroyed and even the then premier teaching and Lassa Research Hospital at Segbwema was abandoned and became a compound full of dilapidated structures. The rebuild has been slow.

Ex SLPP Chairman Benjamin
with Kailuhun District Chairman Bhonapha
at Kenema EbolaCenter
Some of us initially thought that government would use the relative isolation of the jungle areas of Kailahun to work with international health partners and set up Ebola treatment centers in relatively remote locations away from population centers. We were however alarmed when patients were being brought to Kenema from remote areas make use of the Lassa Fever experience of the health workers there, a tragic mistake.

Unfortunately the transportation of Ebola victims to Kenema has turned out to be a disaster in the making,  as the health care workers who have worked for years with Lassa Fever are now tragically finding out that Ebola is a different kind of virus; a potent virus that cannot be handled with conventional isolation precautions,  due to its potency, longevity and the fact that no known cure exists and about 90% of those affected usually do not make it.
Benjamin with Dr. Shek
Umar Khan (Has Tested
Positive too!)

Reports from Freetown today puts the official Ebola figures at 422 confirmed cases with 143 fatalities. What is now very alarming is that many of the fatalities include front line Ebola health workers, who have been handling patients and highly infectious corpses of the deceased. Somehow, breaks in the chain of infection, has exposed some of the front line workers to the virus and they are now dying at disturbing rates.
Over the past months, many health care workers in Kailahun district have died from the outbreak. Now in Kenema, over the past few weeks, health care workers have also been falling prey to the virus. Just yesterday three workers at the Kenema hospital died from the Ebola fever

One of those who died yesterday,  Mrs. Mbalu Fornie, was a veteran Lassa Fever worker from Segbwema with over 15 years of experience working with Lassa patients. Just a week ago, the former Chairman of the Sierra Leone Peoples Party (SLPP) Mr. John Benjamin, who has made the fight against Ebola his latest mission, made one of his regular visits to the Ebola treatment center in Kenema and was given a tour of the facilities by Mrs. Mbalu Fornie who he had known for years in Segbwema, as that was where he was also born and bred.

According to Chairman Benjamin,  the experienced nurse tested positive for the Ebola virus just two days after he left the center and he was particularly devastated to hear about her untimely death.
Just this morning another young Segbwema nurse working at the Ebola center, Momoh Fudie, died from Ebola infection,  in what is now becoming a daily occurrence.
These deaths have created panic in the Kenema government hospital and the workers have threatened to down their tools, unless the Ebola wards located inside the Hospital premises are relocated elsewhere. They have also requested that the Ebola wards be under the control of the French NGO Doctors Without Borders (MSF), as they no longer have faith in the capacity of government health officials to effectively handle the outbreak.
Late Mrs. Fornie in Red

The rapid Ebola spread in Sierra Leone has been propelled by just the right mix of factors.  The areas of infection have a high level of illiteracy,  the people are very suspicious,  their faith in the government is traditionally low,  the messages from health officials have been mixed and chaotic, and  many high level government officials have stayed away from the area preferring to  only make radio announcements from from the relative safety of Freetown, and the message being disseminated is that the disease is incurable.
This cornucopia of factors has created a situation where people are now so afraid that they are hiding their sick relatives, believing that the government is killing them and the government has now called on the police to round up suspected cases and bring them to treatment centers.  I just hope the police are provided with adequate Ebola personal protective equipment.

Dr. Sama Banya (Puawui), a veteran politician and medical doctor and a sage,  who is renowned for his thorough knowledge of Sierra Leone political and sociocultural history wrote what I think is an excellent summation of the situation in the afflicted areas. He wrote the following:

"Dear All,
I trust you and your families are doing fine. I am sending you the latest update on Ebola released by the Ministry of health and sanitation as of last Friday July 18. The figures are cause for concern because they show that the number of new cases and the cumulative death have risen instead of diminishing.
Why would this be happening in spite of the fact that we have been combating the infection since April? I can give two main reasons among others. That there is still a lack of full understanding about the disease among our people. That may in itself be due to the kind of interpretation of the nature of the disease. If you start with “There is NO CURE for this sickness” it no longer matters whether you add that early treatment gives an almost 100 percent cure, it is the initial “HAS NO CURE” which would stick in the minds of our illiterate brothers and sisters who have asked, “Then why bother?”
My opening line would have been that “We have a new and dangerous disease with us, but those who get early treatment have a chance of a 100 percent cure.” There is also the important matter of the reported attitude of some field staff to patients, contacts and their families. From what I have heard some unfortunately appear to be callous in their behaviour.
A sad picture but true nonetheless.

I really can't add much to the old man's words, he paints a picture that is easy to see. Unfortunately Sierra Leone is so politicized that as an opposition politician, he may as well as be making a speech in a cemetery in the middle of the night.

And news filtering from Fretown is that Dr. Shek Umar Khan, the doctor leading the Ebola team has also tested positive for the virus and his life currently hangs in the balance. May God save his life.We will just continue to hope for the best and encourage every Sierra Leonean to constructively engage in this fight against such a dreaded killer.

Saturday, July 19, 2014

Leone Stars-Seychelles 2-0 African Nations Cup Qualifier Commentary

Sierra Leone’s Anti-Corruption Commission Partners up with Songhai Technologies

Sierra Leone Anti-Corruption Commission

Houston, Texas, July 18th: The Sierra Leone Anti-Corruption Commission has reached an agreement with creators of the Sierra Leone App to create a real time corruption reporting link within the App for citizens and non-citizens alike within or out of the country to report acts of corruption to the commission directly from their phones.
The Sierra Leone App

In a telephone call from Freetown the head of the Commission Mr. Joseph Kamara told the Creator of the App, Founder and CEO of Songhai Technologies Mr. Leslie Koroma that he was pleased to partner with his organization to be able to use current 21st Century technological tools to help in the fight against corruption in the country and that even before the agreement was concluded he had already been touting the upcoming feature of the Link within the App to Civil Society groups within the country.
Mr. Leslie Koroma

Mr. Koroma thanked the Commissioner for seeing the value of what technology can do for the Commission and also giving Songhai technologies an opportunity to serve the country. They both agreed that such a move  will significantly help in reducing corruption in Sierra Leone, paving the way for a more transparent and honest society which is a mark of progress for the country.
The Sierra Leone App which was launched in April of 2014 is a multi-dimensional app with a variety of resources for users to access any and everything Sierra Leone and beyond and it can be downloaded from either the Google Play or Amazon App Store or at www.saloneapp.com  for users of Android and Blackberry phones and for those who use phones or tablets with an iOS Platform (Apple products).  The App will be available in a few weeks.

The ACC Link to report corrupt activities to the Anti Corruption Commission is already up within the App for those who already have it on their phones.

The Link works in a very simple manner;
If a Citizen or Non-Citizen sees any corrupt activity that they want to report; all they have to do is tap on the Anti-Corruption Commission’s link within the App with their fingers which in turn will generate a message box where they will then proceed to type in their report. And if they so wish they can attach one or more pictures as photo evidence to reinforce their reports. After completing a report along with attached pictures the sender should then submit their report by just clicking on the Submit button.

The reporting link and the attachment of photos can be done in real time or you can save sending the report at a later time. The photos can be sent in real time as an act is being committed or at a later time from your phones photo gallery along with a well thought out and written report of what you saw.

Monday, July 7, 2014

World Cup Goes to Semi-finals: Once Again it is South America vs Europe

Tomorrow we enter into the deep phase of World Cup 2014, the Semi-finals. Having lived in America for some time, one is tempted to call it the "Soccer World Cup," as Americans do,  but truly it is simply the World Cup; the most coveted trophy in the history of sports, bringing history,honor, respect and awe to whoever manages to clinch it and the enviable title, "world champions!"
Neymar Will be Missed

My prayer is to live long enough to one day see either USA or Sierra Leone clinch that cup! Some may call me a dreamer, but I prefer being called an optimist with a little dose of fantasy.
German Action

Oh and guess what?  Once again the usual suspects are lined up to capture the trophy and take it home. The world cup will not go to Africa, North America, Asia or Australia. It will go once again to Either Europe or South America and that's final.

I could be wrong, but I think only Europe and South America has ever won the world cup and it is not funny,  considering the amount of time, money and other preparations the other areas of the world put into trying to capture this coveted prize.  Somehow the cup always manages to go to either Europe or South America,  and this year will be no different.
On a more optimistic note however,  this world cup will be remembered for the quality of the representation,  as all the teams came prepared, even our African representatives. It was definitely not easy. The Spanish who came with the aura and confidence of being world champions quickly had their feathers trimmed and dispatched back home in a jiffy,  barely managing to unpack their bags before they had to pack them again for an early flight home.

The Quarter finals saw the Colombians put up a spirited defense against perennial World Cup winners Brazil,  but were edged out 2-1 after desperately trying to force extra time. The referee totally lost control of the match and the Brazilians decided it was foul season. This time going back home the Colombian team were not welcomed by vengeful drug lords,  but by a grateful country celebrating a team that had shown the world that Colombian soccer had finally come of age.
A Team Affair

Well now comes the tough part, the semi-finals.  Tomorrow Brazil faces Germany.  If the quality of play over the past two weeks is anything to go by, Germany should be able to dispatch a fractured Brazilian team that will be without their star play and goal maker Neymar da Silva Santos Júnior and their captain Thiago Silva.

Thiago Silva will be unable to report for duty, as he is suspended for the semi-final match for an unnecessary yellow card infraction against the Colombian goalkeeper during the waning minutes of the spirited match. The Brazilian Football Federation appealed Thiago's yellow card,  but Fifa’s disciplinary committee refused to lift the suspension and Brazil will have to do without a major workhorse.

Neymar had to be taken out of the field in pain and taken straight to the hospital due to an outrageous foul by Colombia’s Juan Zúñiga who jumped into the back of the gifted player and kneed him right between the thoracic and lumbar vertebrae,  automatically taking him out of the world cup.

The Brazil Football Federation lodged a complaint against Juan Zúñiga, but Fifa has decided against disciplining the player further as there was no conclusive evidence that it was intentional like the Uruguayan striker Luis Suarez's now infamous bite.
The German team has been solid throughout the tournament and if they continue playing as they have, only the advantage of playing at home with massive support will give the Brazilians a fighting chance. My prediction is a German victory probably with a 2-1 scoreline,  though I will be supporting Brazil and hope they upset the strong but boring Germans.

Sunday, July 6, 2014

The Ebola, Constructive Engagement and the SEA

Ebola Outbreak
We have all in various ways condemned the poor response to the Ebola epidemic by Sierra Leone's Ministry of Health. The loudest critic ironically was the President's own Special Executive Assistant who wanted to seize this opportunity to remind Sierra Leoneans that yes, she is a medical doctor and considers herself one of the best doctors in the country,  though she has yet to give an injection. Of course she just couldn't pass up this opportunity to once again engage in her usual malicious attacks, this time her target being the country's Minister of Health Miatta Kargbo and the State House Communications teams. Now that the journalists in Sierra Leone have decided to just ignore her rabble rousing, she seems to have closed that attack avenue, at least for now.

To raise awareness of her anger at being sidelined in the Ebola response and,  as she says, disrespected by people not yet of "cabinet rank," the Special Executive Assistant embarked on a sit down strike which she publicized daily all over Facebook,  the second of such strikes in as many years.
Sylvia Blyden
Ebola Expert

Unfortunately however, during this second one person strike, the President decided that now was not the time to embark on some unnecessary morale boosting and decided to just ignore her juvenile antics. If she wanted to stay home that was her business.

Well it seems being made to feel unimportant and irrelevant has suddenly paid off, as Sylvia has decided to use what ever authority she still has in her office to finally do something constructive.

The past week has been a visit to Canada during which she invited members of the Sierra Leone community to meet with her as she had important things to discuss. The Blog Correspondent in Manitoba said that except for those who wanted to see the real character in person,  many decided to pass up on the opportunity and instead opted to find better things to do with their time.
Undeterred,  Madam Blyden has decided to use the rest of her visit to go around hospitals and other health facilities in the area to begging for medical supplies,  purportedly for the Ebola victims.
Past Ebola Outbreaks

As is to be expected this Ebola supplies gathering expedition is catalogued on a daily basis on Facebook by the SEA herself,  for her many admirers and fans back in Sierra Leone,  detailing what she would have done had she been the Health Minister and not Miatta Kargbo and vice versa. Sylvia has even let all her admirers know that she will use Seven thousand dollars of her own money to ship the supplies to Sierra Leone, to which one of her admirers replied "mommy,  only you can do this!"

Well in her absence,  there has been new additions to the cabinet and unfortunately,  Ernest Koroma has still seen it necessary to keep Miatta Kargbo at the health ministry,  which creates an interesting logistical dynamic for the now Ebola supply gathering Blyden. Will she, when she goes to Sierra Leone, hand over the Ebola Supplies she has used her office to beg for to the health ministry, or will she set up her own parallel Ebola assistance network so that Miatta Kargbo will not get the praise? Well we will just have to wait and see. No matter what,  Mwen Ke Devire, the Freetown Segbwema blog correspondent, will be ready with the details for the readership of the blog.

Sylvia may yet have the last laugh as news from Sierra Leone is that her arch nemesis David Tam Baryoh's popular radio program Monologue is about to be yanked off the airwaves in Sierra Leone. The loss of Monologue will be a huge loss to political and social discourse in the country, but Tam Baryoh has in recent times been courting some negative controversy and the chickens could just be coming home to roost, metaphorically. But that will be the subject of another Blog post.
Freetown Correspondent
Mwen Ke Devire

Saturday, July 5, 2014

Sierra Leone President makes new Appointments

President Ernest Koroma
Following much criticism over the slow pace of appointments to sensitive positions in the country, the President of Sierra Leone Dr. Ernest Bai Koroma has today made the following appointments:

Amb. Henry Macauley - Minister of Energy.

Mr. Maya Kaikai-             Resident Minister East.
Major Ishmael Koroma

Major Ismail Koroma-    Deputy Minister of Energy I, Distribution and Supply.
Mr. Hassan Barrie-          Deputy Minister of Energy II, Generation and Transmission.
Mr. Momodou Kargbo-   Governor Bank of Sierra Leone.
Dr. Ibrahim Stevens-       Deputy Governor Bank of Sierra Leone.
Mr. Saidu Conton Sesay- Chief of Staff, Office of the President

Tegloma Federation Joins The Fight Against Ebola in Sierra Leone

Ebola Supplies for
Sierra Leone
The dreaded Ebola virus outbreak which is currently wrecking massive havoc in the Mano River Union states of Guinea, Liberia and Sierra Leone has surpassed all former Ebola incidents to become the most devastating one in the history of the disease.

The Ebola virus strain which has surfaced in Sierra Leone is particularly virulent with a fatality rate in the region of 90% and no known cure. The virus results in Ebola Hemorrhagic Fever which results in bleeding from body orifices and a painful death. It is highly contagious.
Ebola Front Line Workers

In Sierra Leone,  the Ebola outbreak has not only been rapid in its spread, but has been particularly devastating in it's impact, effectively moving through the Eastern Kailahun district and causing massive fatalities in the course of just two months. It has now been confirmed in the urban Eastern capital Kenema as many people feared, it is now reportedly moving northwards.
Dr. James Senesie

The first official report of an outbreak of the Ebola virus in West Africa was on March 21st 2014 by the Guinean Health Ministry, with cases in Macenta,  Gueckedou and Kissidougou in the southeastern region of the country. The virus then surfaced in Lofa County in Liberia and was initially thought to have jumped over Sierra Leone.
Dr. Sheku Idriss

Now with the fact that the virus is wrecking greater havoc in Sierra Leone in terms of the high number of cases and fatalities than in Liberia, many are left wondering if the virus had not actually reached Sierra Leone first before Liberia. It could have been that the health care facilities in the Kissi Teng areas where the virus was first reported were never equipped to detect the virus in the first place. Even when the initial reports of infection was first brought to the notice of the authorities the first reaction of the Sierra Leone ministry of health was to deny the incidence of the disease in the country, only confirming the outbreak when fatalities started to occur.

The Sierra Leone government should really have had a strategic Ebola Response team in place in the areas of the country between Guinea and Liberia, as it was just a matter of time given the location of Eastern Sierra Leone to the affected areas in the neighboring countries,  but unfortunately the initial preparedness was not well coordinated as is typical of Sierra Leone, a country not known to be particularly proactive.
More Supplies in Storage

According to the Centers for Disease Control,  as of June 8th there were 528 documented cases with 337 deaths making it the largest Ebola infection on record.

The majority of Sierra Leoneans have now wakened up to the horror of the disease. Iinitially there were some government officials trying to gain political capital out of the poor Ebola response by blaming others. However, there is now a growing coordination of efforts by the Government, NGOS, individuals and Sierra Leone organizations in the diaspora to combat the outbreak and just last week the country's President finally made an address to the nation about the severity of the disease and detailed his government’s response.
Tegloma Federation Secretary
General Amos Alli

One of the first Sierra Leone diaspora organizations to take meaningful action to join in the fight against the dreaded virus was the Tegloma International Federation Inc,  the largest Sierra Leone nonprofit in the diaspora.
As soon as news of the severity of the outbreak started to filter out of the country,  the Tegloma Washington Chapter led by their President Momoh T. Vandy started to mobilize funds and medical supplies for Sierra Leone in order to assist front line health workers minimize the spread of the infection.

The Tegloma Federation Chairman Mustapha Sheriff set up a rapid Ebola Committee led by two medical doctors, Dr Sheku Idriss and Dr. James Senesie,  both US trained medical doctors from Daru and some other prominent Tegloma members to coordinate a response. The committee immediately worked with the Washington Chapter to acquire thousands of dollars worth of Personal Protective Equipment (PPE) in order to help front line workers deal safely with the outbreak.

Tegloma has initially flown six bags of medical supplies to Sierra Leone which were presented a week ago to the health ministry to be distributed to front line Ebola health care workers. Each bag contained 200 medical protective gowns,  500 face masks, 400 shoe covers, 400 head covers, 45 sterile gauzes, 400 non-sterile gauze and 16 protective goggles. The organization has also acquired many boxes of medical supplies and PPEs to be shipped to Freetown as soon as possible. 

The Tegloma Federation Board Chairman Abu Bonapha and Federation Chairman Mustapha Sheriff have also launched a massive $25.00 per member fundraising drive. The goal is to make funds available to the district authorities in the affected areas to buy infection control agents like chlorine and also assist in education efforts.
Sierra Leone President
Dr. Ernest Bai Koroma

Tegloma members are particularly encouraged that the country's President Ernest Bai Koroma recognized their initiatives in his first address to the nation concerning the viral outbreak.

Sierra Leone's fight against the virus has been challenging, as initially there was a lot of misinformation about the disease. The situation was not helped by the infighting between the Health Minister Miatta Kargbo and the Special Executive Assistant to the President Sylvia Blyden who used her Awareness Times paper to portray the health minister as inexperienced,  
incompetent and uncaring. However, there are now reports that Sylvia Blyden herself is out of the country trying to raise medical supplies for the outbreak and many Sierra Leoneans hope action will now replace blame.