Sunday, August 31, 2014

Miatta Kargbo Recalled to State House

Miatta Kargbo Sacked
Miatta Kargbo has been recalled to State House to serve in the Strategy and  Policy Unit until further notice"

The above was the statement released in Sierra Leone last week, announcing the "sacking" or "recalling"of the most incompetent Health Minister in the history of post independence Africa. This sacking of course came only after mountains of pressure had been piled on Sierra Leone's President Ernest Bai Koroma. He may finally have been convinced that his health minister was the very symbol of incompetence, both in how she prepared for and how how she responded to the Ebola crisis that is now battering the small West African nation.

When Ebola entered the country from Guinea and Liberia, the health ministry was totally unprepared. There was no comprehensive strategy, the Ebola test kits that had been stockpiled were expired, the personal protective equipment-PPEs- used by the health workers were for standard precautions and totally inadequate for Ebola, and consequently the infection spread as quickly as wildfire in the harmattan.
Poor Quality PPE in Sierra Leone

Miatta Kargbo's dilemma could be likened to a mediocre student who has prepared studiously for junior school exams being forced to take the final year exams of a university honors program with the expectations that she will pass with flying colors. It was never bound to happen. The computer experts have a term they call it;(GIGO)- garbage in, garbage out.

Everybody, except President Koroma, knew that Miatta Kargbo was a walking disaster. How she managed to stay as Health Minister from May to August, the President will one day be forced to explain to the souls of the hundreds who have died due to the disastrous handling of the Ebola outbreak in the country. Many people, including those very close to the President have blamed the hapless minister for the poor response to the crisis.  In my honest opinion, what many of her critics fail to comprehend is that this was truly a failure of presidential leadership. Miatta Kargbo's failure was the failure of President Koroma to see that square pegs are just not meant for round holes. If you have a round hole, you look for a round peg.
President Ernest Bai Koroma

President Koroma is the type of leader you need in a country which is completely disaster free, a country where the only role the ministers play is to praise the President and shower him with superficial platitudes. The only blessing that Sierra Leone has is that during country's protracted civil war, Ernest Bai Koroma was never voted for as President, as that would have been catastrophe of unimaginable proportions.

In Periods of crisis, President Koroma has proven over the years that time and again, he simply cannot rise up to the challenge of good leadership. The President's major flaw, both as a leader and a human being, is his inability to make quick decisions and his affinity for meaningless platitudes. In periods of crisis, he has sometimes asked people to engage in periods of fasting. One irate lady once said that if she had wanted a President who encouraged her to fast, she would have voted for her pastor.

President Koroma is so indecisive that he will take two months just to appoint a cabinet, only to appoint people like Miatta Kargbo who are simply clueless or other characters with dubious backgrounds and shady credentials. Just a few months ago, the president's own Chief of Staff,  Dr. Richard Konteh was caught forging his signatures on official documents. The fiancee of this same Chief of Staff, a 50 year old nanny in USA named Kadiatu Sahid Kamara, who also happens to be a close acquaintance of the President is currently facing the possibility of spending 22 years in jail in the state of Maryland, USA for having defrauded a family she was employed to as a nanny out of a total of $430,000.00 by writing scores of fraudulent checks, the same crime her fiancee Richard Konteh is in jail for in Sierra Leone. Richard and Kadiatu were a match made in forgery heaven, Sierra Leone's own real life version of Bonnie and Clyde.
President Koroma with Criminal
Nanny Kadiatu Sahid Conteh

 Just a few months ago another Koroma appointee, a deputy Minister of Education Mahmoud Tarawally, who was supposed to protect the interest of students in the country, was charged with violently raping a female student.  He had lured her on the promise of helping her get an overseas scholarship and then proceeded to brutally violate her in broad daylight. She ran to the police naked and bloody and today he is still walking about a free man.
Ex-Dep. Education Minister Mahmoud
Tarawally (The Rapist)

These are just a few examples of the poor choices among a catalog of many, made by the president, even when he spends months making up his mind. The President is simply not a crisis leader. Two years ago a simple cholera outbreak in the country quickly got out of hand, becaused at the same time the health ministry was embroiled in a massive corruption scandal. President Koroma's response to crisis is to simply order the many journalists whose pockets he greases to engage in widespread campaigns of misinformation. President Koroma is the rich uncle you want to enjoy Christmas with, but who you do not want to be with in a boat that is sinking.

The majority of Sierra Leoneans were not only disappointed by Miatta Kagbo's incompetence, they were even more stupefied by her lame statements. She initially blamed the promiscuity of health workers for the spread of Ebola, even providing the names of some of them as boyfriends and girlfriends in Parliament.

According to the press release announcing her removal from office, the Minister has now been transferred to State House to serve in the Strategy and Policy Unit, a move seen by many as an undeserved reward for her monumental failure. Whatever this unit is responsible for, one can only hope it has nothing to do with Ebola.

The new Minister of health Dr. Abubakarr Fofanah, a graduate of Sierra Leone's College of Medicine was Miatta's deputy, but it is rumored from reliable sources that they never got along. The President's loquacious Special Executive Assistant, Sylvia Blyden, who is apparently very close to the new minister, has been praising him in glowing terms all over social media. One can only hope that even if half of this praise is true, there could be the chance that a better outcome may be in the future for this crisis.

Many Sierra Leoneans I know heaved a collective sigh of relief when the announcement was made that the minister was relieved of her duties. One of her ardent critics even went as far as saylng that even a chimpanzee from the forests of Congo would do better than Miatta. We will just have to wait and see, as my honest opinion is that the incompetence in Sierra Leone is at the very top.
President Receiving $50.00 check from
Sierra Leone Football Association

These days money to fight Ebola is pouring into Sierra Leone from all over the world to fight the Ebola plague, and guess what, now that the money is pouring in, the fight against Ebola has suddenly moved from the health ministry to State House. It took much pressure from journalists last month for the President to even make one visit to the Ebola infected areas. Now that the dollars are pouring in, the President is now personally in charge of the Ebola response. With Ebola cash pouring in, there are already reports filtering out that Ebola funds are being mismanaged and Richard Konteh is not even there to forge checks. May God bless Sierra Leone.

Sunday, August 24, 2014

Ebola Updates from Segbwema and Kailahun: Stories from the Epicenter

Late Dr. Khan Conducting Ebola
Workshop in Segbwema
"Prevention is better than cure" has been the mantra of the leaders of Segbwema, the second largest town in Kailahun district. Before the Sierra Leone government even acknowledged the  seriousness of Ebola in Sierra Leone, the leaders of Njaluahun Chiefdom recognized the likely impact of the disease and with the help of the health authorities launched an intense and effective Ebola awareness campaign in Segbwema and the surrounding towns. This was because because Lassa Fever, another hemorrhagic fever far less popular than Ebola, had killed hundreds of people in those areas in the period of the 80s
Hon Abu Jajua Segbwema

The Member of Parliament for Kailahun Constituency 7, Njaluahun Chiefdom, Hon. Abu Jajua, the youngest MP in the history of the constituency coordinated with the Paramount Chief Sheriff Coker Jajua and with the help of the health ministry launched some successful Ebola educational workshops in Segbwema that were led by late Dr. Sheikh Umar Khan who was then the lead doctor at the Lassa Fever Project and was to soon become the leading Ebola expert in the country, shortly before he himself succumbed to the virulent outbreak.
Workshop Attendees listening

In the educational workshops, Dr. Khan went into great details about the nature of the new virus, its virulence and what the citizens needed to do if there was the incidence of an outbreak in the town or the surrounding localities. The people of Segbwema, with many years of experience dealing with the deadly Lassa Fever virus, were very receptive to the message and took appropriate precautions, storing and using chlorine and taking other effective secondary precautions. The fact that Segbwema was the home of Nixon Memorial Hospital, the first headquarters of the Lassa Fever Research Project was also very instrumental in getting the people to cooperate.

Another strong voice from Setbwema that was added to the fight against Ebola in the chiefdom has been that of John O. Benjamin, a prominent son of the town and an esteemed individual who had held many prominent positions in Sierra Leone and therefore commanded immense respect among his people. John Benjamin had interacted with health care workers and told the people of the town to be serious about the precautions to take with Ebola, as the disease was real, was in the country and was deadly.
Segbwema Paramount Chief Receiving
Chlorine from ADM Kamaraimba

A month or two after Dr. Khan's workshops in Segbwema, Ebola hit Daru town with the ferocity of a storm. Daru was just seven miles from Segbwema and the indigenes of both towns interacted on a daily basis. Segbwema was more populated than Daru and in the absence of the timely Ebola education, the town would have been affected almost as badly as its neighbor, if not worse. However, when Ebola came, Segbwema was better prepared than most towns in Kailahun district because of effective earlier education about the virus and the fact that the people had listened.

In the fight against Ebola, Segbwema has many advantages compared to other towns in Kailahun district. The town has always had a strong history of Catholic and Methodist educational institutions and consequently had a higher level of literacy than most towns in the district. Almost every child born in Segbwema has the chance to obtain at least primary school education and therefore there is higher than 60% literacy among the youths, a figure much higher than comparable localities. Segbwema also has the Nixon Memorial teaching hospital, which was once the leading health care institution in Eastern Sierra Leone and had trained many of the nurses in the area. 
Mr. John Benjamin in Segbwema

Unlike inhabitants of other towns in the area with low awareness of the efficacy of Western medicine who mostly consult traditional healers and herbalists when they get sick, the people of Segbwema have always used the hospital and clinics or see independent health care practitioners when they get sick. They therefore had a more progressive view of health and wellness than neighboring towns whose inhabitants relied on the herbs and invocations of traditional healers for every conceivable ailment and sometimes only visited the hospital when it was too late.

Ebola has not however escaped Segbwema. A few weeks ago, Murray Belewa a descendent from Mendekelema, a town just two miles from Segbwema who was a government nurse in Daru suddenly felt very ill. Murray had attended the Wesley Secondary school in Segbwema and had more faith in the healthcare provided in Segbwema than Daru. He therefore made the fateful decision to come to Segbwema to seek help. 
Nixon Memorial Hospital Segbwema

Upon arriving in Segbwema Murray sought treatment at Nixon Nixon Memorial Hospital and was  initially treated by Nurse Joe Nallo who was working with the doctor at the hospital. Unfortunately Nurse Murray had Ebola and succumbed to the disease. A few days later, Nurse Joe Nallo who was the brother of the Acting Principal of Wesley Secondary School, Mr. Allan Idrissa Magbity, also became sick and died. Then Allan Idrissa, the Principal, and his mother also became very sick. Unfortunately Allan Idrissa died and the entire family was quarantined and taken to the Ebola Treatment Center in Kailahun. Their house was quarantined and sprayed and even though they were in the middle of many groups of houses, the disease did not spread in the neighborhood. In total 4 members of the Nixon staff who treated Murray have now died out of the seven who had direct contact with him.

According to the Member of Parliament Hon. Abu Jajua who is currently on a food distribution drive, Njaluahun chiefdom currently has 38 Ebola cases, with 14 deaths, 16 in camps and 8 survivors. Compared to other Chiefdoms in Kailahun such as Jawie and Kissi Teng, Njaluahun chiefdom has fared relatively better and should be a guide to the Ebola task force in the country that the primary tool to employ in inhibiting the further spread of this menace is "effective education," delivered by health care practitioners. Some of the short Ebola skits (plays) I have seen on social media are helpful, but some just succeed in propagating fear and misconception.
Hon Abu Jajua distributing rice in
his constituency

In Kailahun, there has been some problems between the staff of Medecins Sans Frontieres (MSF) or Doctors without Borders and those of the World Health Organization (WHO). A Senegalese working with WHO has contracted Ebola and the MSF staff are of the opinion that the WHO staff wre not taking the proper precautions. No MSF staff has contracted the virus even though they have been leading the treatment of the disease. As they all share the same hotel in Kailahun, the MSF staff have asked the WHO staff to vacate the hotel. The WHO staff have therefore left Kailahun with their lab technician which means that blood samples now have to be taken to Kenema for tests, further complicating matters.

Brigadier Julius Maada Bio
distributing Rice
The most urgent problem right now in the quarantined areas is the availability of food. In spite of the billions being collected to help in the fight against Ebola, the government has sent only bulgur wheat as food aid. Last week the former military leader of the country Rtd. Brigadier Maada Bio distributed 300 bags of rice to the victims, but this is just a drop in the bucket, as the afflicted areas have practically seen a drop in farming and other related agricultural activities over the past few months and this year's planting season was practically abandoned, a harbinger of the hunger that will descend on that area over the coming months in the absence of any harvest. Mr. Francis Keili an engineer and politician has launched a foundation to help the children of medical workers affected by Ebola and plans to make it a formidable foundation with international outreach. Dr. Jonathan Tengbe, another citizen of Kailahun district has launched the "Feed the People Campaign" to support food delivery in the affected areas. Dr. Tengbe was also born in Segbwema. He has already donated twenty bags of rice to the Chiefdom Speaker of Kissi Kama.
Vandi Jaward: Ebola Survivor

A radio presenter in Kenema, DJ Snow, this past weekend lamented the sorry plight of the Ebola survivors in the country. When survivors go back to their areas, people treat them as outcasts. The fear,  ignorance and the belief that survivors could be carriers has become so widespread that many of these people, who should be considered extremely lucky, have now become pariahs, treated as if they were an abomination, scorned and turned away by their relatives and friends. The radio presenter said that most of the survivors were discharged without food and are finding it hard to survive. A spokesperson for Sierra Leone's ministry of health Sidie Yayah Tunis was asked what the health authorities were doing to provide sustenance to the Ebola survivors. His answer was that there was nowhere in the world where patients are discharged from hospital and given money. This statement was particularly disturbing, given the nature of the disease and the fact that these were people who were being discharged after a bout with a terrible disease and their home areas were quarantined while they were shunned by their acquaintances. How were they expected to survive. The sad fact is that if nothing is done, Ebola patients will survive the disease only to die from hunger, unless some of the monies being donated to State House be apportioned to help not only the sick, but the survivors too.

Friday, August 1, 2014

People in Ebola Areas Badly Need Education about the Infection

Sierra Leone Ebola Outbreak
I just finished listening to a WhatsApp audio file in which a fellow from Kailahun district,  the epicenter of the Ebola outbreak in the country is conveniently denying the existence of Ebola, blissfully oblivious of the terrible nature of this virus, and attributing all the alarm to some sort of conspiracy by the All Peoples Congress ( APC ) to kill people from that area and keep them from voting in future elections.

Bob Marley one wrote, "fools die for want of wisdom, " that statement is prophetic in the face of such glaring lack of education about Ebola Virus.
Segbwema MP Abu Jajua Conducting
Ebola Education with Late Dr  Khan

The really scary thing about the clip is not even the degree of ignorance manifested by this fellow in the face of such a devastating epidemic,  but the fact that he claims that they are telling their people and children not to take any medications or treatment provided by outsiders for the disease, even if they came from America and Germany, and to chase them and kill them. He said that they should attack even the President of Sierra Leone if he was the one that took the treatment to them.

Sad to note too is the fact that the fellow is obviously totally convinced about the truth of this so called vast government conspiracy, that the journalist or whoever was interviewing him did not even see any need to argue or educate him. The interviewer was simply at a loss for words.

This audio clip, even though it is so totally disheartening, is very revealing in many ways:

Firstly, it shows that the authorities in Sierra Leone still have a long way to go in trying to convince the largely illiterate and highly superstitious people in these areas where the outbreak started that Ebola is real, it kills and does not care whether you belong to SLPP,  APC or even the Ignorant Party. Ebola simply does not discriminate and doesn't care about tribe or region. 

Secondly, it shows that in trying to educate people about Ebola in these areas, the messenger is equally as important as the message. It is absolutely crucial for the government to dent holes in these insane conspiracy theories by spreading the message through individuals and media who bear the trust of the locals. In the case of this fellow he simply does not trust those in power, unfortunate but true.

A third and very important revelation is that whatever task force is put together to tackle this outbreak should be non-political and should include people who would add value to the task force by the skills,  experiences and knowledge they bring to this fight,  devoid of their current or past political affiliations. The task force should include people experienced in disaster management, epidimiologists, virologists, etc. The "chop the money" types should be kept away from the management of this crisis as far away as possible.

In order to tackle this outbreak,  the help of everybody is required. All such help  should be channeled through the health ministry, or whatever organ is instituted to tackle the outbreak so that the activities of individuals are coordinated,  duplication is avoided, proper health protocols are followed and a national disaster management plan is adhered to.
President Declares State of Emergency

President Ernest Koroma has already talked about setting up an Ebola task force that would be based at State House and would lead the official response to the outbreak.  The work of this task force should hopefully be to complement and strengthen whatever good work is already being done. The President should ensure that people who are always the agents of controversy are kept as far away from this task force as possible. All official government announcements about Ebola should now be through the task force. The government should speak with a single voice.

In addition to the local ignorance about Ebola,  the right wing conspiracy theorists in USA and the diaspora have also started to do what they are good at, putting out fake scientific papers and the usual conspiracy theories about Ebola. Some are already saying that it is a failure of a weapons lab at Kenema and that George Soros and the USA government are involved.  There are also papers purporting that the local "Bitter Kola" is efficacious in the management of the disease. What is dangerous about these diaspora based conspiracy theories and papers is that our people have the tendency to believe most publications that come from overseas and hardly bother to check the integrity of the source.  It is therefore very important that the authorities be on the lookout for these conspiracy theories and debunk them before they become other obstacles to fighting this outbreak.

Even though the fight against Ebola should be non political,  it is important to recognize the overarching impact of politics in Sierra Leone.  Politicians who are trusted in the different areas should be drafted to help with Ebola education. It is however important that the focus be on local politicians and not the big crowd pullers, as what you don't want in the midst of this outbreak is thousands of people gathered to follow a national political figure. Ebola spreads faster this way, so absolute care should be taken to avoid campaign style events in the affected areas, as this will only exacerbate rather than help contain the spread of this contagion.

Tuesday, July 29, 2014

Dr. Sheik Umar Khan Passes away in Sierra Leone

Dr Sheik Umar Khan
In these days of unnecessary politicization of life in Sierra Leone,  it is rare for the people of the troubled West African country to display solidarity on anything. Yesterday however,  Sierra Leoneans from all walks of life were united in their grief over the death of the doctor leading the fight against Ebola in the country Dr. Sheik Umar Khan.
Dr. Khan Conducting Ebola
Workshop in Segbwema

Dr. Khan was a Lassa Fever specialist who saw himself at the forefront of the country's fight against the dreaded Ebola virus that is currently on the rampage in Sierra Leone and the neighboring countries of Liberia and Guinea,  with recently reported instances in Mali and Nigeria. Lassa Fever, which is spread by a species of small mice common in Sierra Leone, was a major scourge in the East of  the country back in the 1980s. It is characterized by extreme fever and an inflammation of the mucous membranes and was extremely fatal in those days.
Dr. Khan With John
Benjamin in Kenema

However, with the timely intervention of the US sponsored Lassa Fever Research Project located at the Nixon memorial hospital Segbwema in the 1980s and the tireless work of infectious disease experts like Austin Demby, Dr. Aniru Conteh and some other virologists, together with the heroic nurses of the Lassa Team based in Segbwema, Lassa Fever was eventually brought under some control, but not until the leading doctor at the time Dr. Aniru Conteh lost his life to Lassa Fever,  after many years saving countless lives. The Lassa Fever Research Project was relocated to Kenema at the height of the war.
Ebola Worker
Sierra Leone

39 year old Dr. Sheik Umar Khan,  a graduate of the Sierra Leone College of Medicine and Allied Health Sciences, (COMAH) the leading medical training institution in the country, was heading the Lassa Fever team at Kenema when the Ebola outbreak was reported in Kailahun district, eastern Sierra Leone.  Given the similarities between Lassa Fever and Ebola, it was natural that the Lassa team at Kenema, which was the most adequately prepared to provide a local response to the outbreak, take the lead in combating the virus before the intervention of international organizations with years of experience fighting the outbreak in Congo and other areas of Eastern Africa.
Talking to Segbwema People
about Ebola

As soon as the Ebola threat became imminent,  Dr. Khan started conducting Ebola education workshops in Kailahun district. One such workshop in Segbwema was reported in one of my earlier blog post. Dr. Khan had in a recent interview about his work with Ebola patients expressed personal fear of contracting the disease himself,  but had put his service to the patients ahead of his own personal fears and spent many hours trying to help people afflicted with the terrible disease.

Unfortunately, Ebola patients are highly contagious and in the majority of incidences of outbreaks of the virus,  health care personnel dealing with the victims have been among the highest casualties. Sierra Leone has been no different.

Since the outbreak of the disease in the second quarter of 2014, many medical personnel at the front line of care have paid the ultimate price. From Kailahun to Kenema,  many health care workers have lost their lives to Ebola, especially between May and August of this year.
Just last week,  four nurses at the Ebola center in Kenema including the head nurse with over 15 years experience dealing with Lassa succumbed to the outbreak.  It was at this same time that the 39 year old Dr. Khan was reported to have contracted the virus and was evacuated to the MSF treatment facility in Kailahun.

Dr. Khan's infection with the Ebola virus has been widely reported in the local and international press. Get well messages and prayers for him have poured in from all over the world since he contracted the virus.

Just this past weekend there was some encouraging news from Kailahun, as he was reportedly responding to care and seemed to be in high spirits. Many thought that with the timely and expert intervention by the experienced MSF team he would be one of the success stories,  but alas that was not the case.

Yesterday morning we received news that the heroic doctor had succumbed to the virus and become the latest member of the grim statistics of those who did not survive the outbreak. 

Just today it was reported that all flights to and from Sierra Leone and Liberia has been canceled,  especially after the death of an airline passenger from Liberia who died in Lagos,  Nigeria,  one of the most densely populated cities in Africa. We are now learning that the victim is one David Sawyer a recent of the state of Minnesota who had gotten a job in his home country Liberia and frequently traveled between USA and Liberia.

The Ebola infection, characterized by high fevers, emesis and hemorrhaging from open body orifices, has a painful course and currently has no known cure. The current outbreak in West Africa is reported to be the deadliest in the history of the disease.

Monday, July 28, 2014

Sierra Leone and the Politics of Ebola

The Ebola Candidates
If there is one thing Sierra Leonean politicians excel at, it would be the politicization of tragedy. While the Ebola outbreak is growing rampant in the country, ravaging the countryside,  striking fear and terror, and bringing the cold hand of death in the unlikeliest of places, the infection is fast becoming the latest publicity tool in the hands of our country's chronically political statesmen and women.

To our President's Special Executive Assistant  Sylvia Blyden,  Ebola fell like manna from heaven. Our President's Special Assistant now sleeps with a laptop either under her pillow or between her knees, ensuring that the first word she types upon waking up every morning is -E-B-O-L-A, Ebola.

SEA's Ebola Plane
To a person like the SEA, the Ebola has been a golden opportunity to get back into the limelight at a time when many people had started ignoring her daily drama and meaningless rants. Ebola has replaced seditious libel. Rumor has it that the first thing the SEA does every morning with religious regularity is to call Kenema to update her Ebola journal; how many tested,  how many negative,  how many positive, how many deaths. Every single death is of course Miatta Kargbo's fault, as she had never asked the SEA for advice and now the people were dying.

Kamaraimba's ADM Chlorine

Fresh from her recent Ebola trip to Canada,  the SEA made sure that there were cameras at the airport to snap the plane from all angles when it landed. Those at the airport said she made a grand entrance, as the Ebola hero of the  Sierra Leone.  Just as Jesus rode into Jerusalem on a camel to save the jews, so did the SEA land in Freetown to save the Ebola afflicted. Word was that anytime a journalist came on the scene, they would take all the supplies out again and load them on trucks for the photo opportunity.

Well Mohamed Kamarainba Mansaray, the former potential flagbearer of the All Peoples Congress (APC), who was told he was never APC and who has now formed his own party, the ADM, was not going to be upstaged. He also went to Kailahun district with his own supply of drums of chlorine,  ensuring that ADM was boldly printed on each drum, so that the people will get the message,  "After Ebola nar MKM."
No Lipstick Shop in Luawa?

Miatta Kargbo has yet to visit Kailahun,  but as she says, "all the workers at the Ebola centers are her heros." She just doesn't think her make-up will hold well in Kailahun. There would probably be no bottled water in case she runs out. Somebody said that Kailahun had rats too. Since she came back from America,  she still hasn't gotten used to sleeping without electricity and where would she get her nails done, Segbwema? Somebody also told her that in the whole of Kailahun town, there is not a single shop that sells lipstick. How can she survive in such a place for even one night?

Now, who were these journalists saying the President should go to Kailahun,  incurring the wrath of the President's own personal man of God in New Jersey,  the well proportioned Kabs Kanu, a d'jeliba even my Madingo brothers would have been proud of.
"How dare they?" He wailed, "How would they expect the father of the nation,  the fountain of honor,  on whose divine shoulders the destiny of the country rests. How dare they,  to expect him to go expose himself to the Ebola virus?"
Helicopter Without Fuel: Amen

Well EBK decided that this time he was not going to listen to the Reverend. State House sources quoted the Pa:

"I love Kabs Kanu like he loves Burger King, but this time I am not going to listen to him." With that said,  President Ernest Koroma got on a red helicopter to go see Ebola with his own eyes. The President reached Kenema and saw the torment on the faces of the people.

Unfortunately they could not go to Kailahun,  the epicenter of the Ebola outbreak.  The Presidential helicopter had run out of fuel, and as there was currently no functional filling station in Kailahun. Somebody told the President that there was only "jebu" (black market) fuel in Kailahun. The trip was canceled.  The President wanted badly to go to Kailahun,  but he ran out of fuel and he did not fancy putting "Jebu" fuel in his red helicopter!  Kabs Kanu's prayers were answered.
Kamaraimba in Segbwema

Today we heard that Vice President Sam Sumana finally broke his long silence on the Ebola. God be praised!  Despite Ebola hitting Kailahun hard,  a district neighboring his home district of Kono,  Sam Sumana had been loudly silent on the outbreak, not even a word. But now that other potential presidential wannabes have started talking, he also will talk, and talk he did. 

Sam Sumana wants Sierra Leoneans to know that he had not kept his mouth shut on the Ebola outbreak by accident. As Chairman of the National Platform for Disaster Management, he had quickly convened a meeting as soon as he heard about the outbreak in Kailahun. As soon as State House heard about this, they yanked the National Platform for Disaster Management from the Vice President's office direct to State House before you could say, "red lorry, yellow lorry!" Sam Sumana was not going to make any name with this Ebola.

Realizing that he was marginalized and sidelined as is now so common,  he decided to keep quiet. But now that the outbreak is getting serious,  he just can't keep quiet anymore. Is anybody listening?
Well VP, how can Kamarainba distribute Chlorine before you?  You better head to Segbwema!

As Ebola becomes the new politics of Sierra Leone,  we hope that at least something good will come out of all this posturing.

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.