Sierra Leone!!! “Re-the above we are at water shed” Fighting the ebola war. It came in unceremoniously as a national disaster. It has now developed and graduated into a state of man made disaster. With this early warning signal we should urgently react and fight with all our available resources to be complimented with that of the international community.
As a nation we have to swallow our pride and accept that we do not have the human and material resources. Our focus should now be on negotiating with the international community to urgently supply us with a minimum of fifteen prefabricated field hospitals fully equipped with laboratories and solar lightening systems. An additional five mobile laboratories, which will be ideal to cover long distances.
Canada has offered a mobile laboratory. IFRC has also donated a field hospital. These hospitals should be complimented with a team, each of medical experts in the related fields including laboratory technicians and medical physiologists. We will also require tented camps with solar lightening facilities as staffing accommodation. They should be equipped with portable room refrigerators. This recommendation is based on the fact construction of buildings with cement, sand, blocks and water is very time consuming as it will take twenty one days for a cement mortar to cure.
It takes 10-15days to install prefabricated buildings depending on the materials. Tented materials are fast to install, each unit should have a minimum of three vehicles, two for transportation of patients and one for transportation of corpses. All these materials are available at various health emergency warehouses located at strategic locations under the World Health Organization (WHO.)
Application by the Head of State through the country office to the WHO world representative will facilitate the release by air. This is mandatory under the emergency disaster preparedness program as ebola has been declared a global public health emergency.
The proposal of developing Kerry town as an isolation centre is a move in the right direction. An isolation center should be located quite a distance from any human settlement with adequate portable pipe borne water. There are hand dug water wells at the area but these should be complimented with drilling of water bore holes by one of the local companies to provide adequate water for the field hospital and the staff residential area. Adequate water is the key factor in the curative programme of ebola.
As we have now conceded our failure of quickly responding to the early warning signals when we received the information of ebola in Guinea, (which is all now history) we should now quickly buttress our sensitization programme to minimize and eventually contain and eradicate this deadly ebola saga
To address this issue we should formidably adopt the following:-
1. The ongoing advert of renewal of gun licenses should be immediately suspended for about two years. Bats and bush meat are carriers of this deadly ebola virus. Renewal of gun licenses will encourage the hunters and famers to kill bats and bush animals, collect them, clean the meat, sell some and cook some. Cameroon, Liberia, Nigeria are now struggling with the banning, selling, cooking and eating of bush meat and bats. If we should fail in suspending this action of renewal of gun licenses we will amplify this saga to a man made disaster.
2. We are presently desolate and depressed. The entire country is in a state of confusion typical of a drowning man or woman who is ready to grab a thread for survival knowing fully well that it is a loosing battle. In this regard I fully share the concern of Mr. Andrew Keilli in his recent article referring to the recent saga of salt and hot water for bathing as a curative measure for ebola as dangerous.
The information that this recommendation is from the man of God the prophet from Nigeria is a case in point of too many cooks spoils the broth. About twenty people died in Nigeria after utilizing this unscientific curative method.
WHO has complained that our sensitization process is weak because in Sierra Leone the citizens are receptive to information from the traditional and religious leaders and traditional healers (herbalists). This is a problem in Africa and Asia. I am aware that religious leaders will complain that I am threading on their toes but we have a choice of a scientific approach with a possibility of survival or a reckless unscientific approach, which will take us to the grave. The Ministry of Health (MOHs) in their sensitization programme cautioned religious, traditional leaders, and healers to advocate to Sierra Leoneans (members of churches and mosques) that ebola has no curative medicament for prevention, i.e. ‘don’t touch’ ‘don’t eat bush meat and bats.’ Immediately report to the nearest health centre on suspicion of the symptoms of very high fever, acute diarrhea, frequent vomiting, and blood from the extremities, feeling very weak etc. This is the key scientific proactive measure. The government should give very strong backing to this MOHs scientific sensitization with strict instructions that any contrary sensitization will be construed as violation of the public health state of emergency. Information is power especially if it comes from the press.
The recruitment of health workers for the curative programme of eradicating ebola should be under a military discipline. They are front line soldiers so they should sign a contractual agreement that they are prepared to work under high risk conditions with very attractive incentives in addition to their salaries. An insurance scheme should be provided. Protective clothing, accommodation with adequate security should be provided at a distance of a minimum of fifty metres from the isolated field hospitals equipped with beds, solar lights, TV/radio, refrigerators etc. food should be provided three times a day.
The medical condition of confidentiality should be strictly observed. Because of the intensive workload with protective clothing, they should work under a shift system of about two weeks with a week’s break after the term period. I assume they will have to work under the expatriates as counter parts “on the job training.” Due consideration should be given to their dependants in the form of food aid to reduce their anxiety. They should be provided with chorine.
The head of the field hospital will have to decide as and when they should utilize mobile phones under the strict medical conditions. The perimeter area of the isolation field hospital should be fully fenced with wire fencing and adequate security personnel. Visitors of workers will not be allowed in an isolation field hospital area to prevent infection of the contagious virus. The information that President Obama has opened a hot line communication with President Ernest Koroma is very encouraging.
We on our part should comply with all the sensitization conditions of the MOHs to win additional support from USA and the international community. WHO should also step up their support to compliment the activities of the international NGOs, MSF, and IFRC. Funding should also be provided to support logistics of the programme and other activities.
By George Labor
Tuesday September 23, 2014