By Titus Boye-Thompson, Freetown, Sierra Leone.
It is a shame that while Ebola rages in Freetown and the North of Sierra Leone some still fail to have a grip on their consciences but look to feeding off political trash and mockery of personalities.
There is an impending explosion of the epidemic as we see the overturning of the mechanics of how the disease is being dispersed. The most appalling situation for now is the relative laxity with which medical and health personnel are conducting themselves and to the extent that the spread of the disease has since stopped from being transmitted from patient to carer but now goes intermittently from carer to a dispassionate public unaware of the ramifications of a relaxed engagement in certain communities.
The case of 31 people now being put under quarantine in Freetown is appalling when you consider that these people by now should have been used to triage methods of dealing with all patients. They were deficient in their treatment of a pregnant woman who had come to them from Port Loko and in the process, had to deal with profuse bleeding during childbirth, and to some extent with some handling of the said patient without proper protective equipment.
The same applies to the case of a woman who came in ill from Kambia and settled in a village near Lunsar. Shortly after arriving, she was visited by people from most of the households in that village and after her death was confirmed as Ebola related, the entire village is now quarantined.
These are very serious situations that should raise the alarm for all of Sierra Leone. The cycle of infection has not been addressed sufficiently to end it and in the event, the cycle is now self perpetuating. The conditions are not being made amenable for control of the disease in the Western Area and the Northern province and the self perpetuation of the disease is increasingly becoming a function of malaise and ineptitude.
President Koroma is upset at the lack of progress and for once, he is losing patience even with the attitudes of those who should have a firmer grip of the situation. When a sitting Parliamentarian is involved in the washing of a dead person with the disease, the idea itself becomes unbearable. The responsibility transfer is disjointed because those who are looked upon to provide leadership are openly seen to be dismantling the focused structures that have been set up to constrain the spread of the disease. It is a seeming disconnection of the intelligentsia from the communal leadership that can be attested to as causal factor for this predicament.
The slippages from the North is also a matter of serious concern and here is where we see the decadent approach of turning a blind eye to the obvious. There is a mixture of communities along the Guinean border and with such porous enclaves, it is apparent that border closures are not effective in policing fluidity of movement. The onward journeys are being made by non-traditional routes, using sea ways and river paths to reach further south towards the Western Area. Invariably, most of the slippages arrive in Freetown via travel pathways that are inadequately policed. It is the case that all efforts to police the shoreline between Freetown and Port Loko, specifically Lungi, is not being effectively handled. The issue is now being manifested as one of resources and a lack of effective policing equipment and facilities.
Sadly, at a time when a final push to rid Sierra Leone of Ebola, there is a feeling of donor fatigue and a concentration of donor funding in areas that rely on the sustenance of international aid agencies rather than to build the capacity of community based organizations for them to engage their communities as trusted mediators and interlocutors.
The leveraging of community capital is not being adequately utilized and hence the attempts to bypass the health guidelines are supported by ignorance and improper understanding of the ramifications of their actions. The final push to rid the North and West of this scourge should be taken more seriously than is currently the case and the perambulation of foreigners in fast white jeeps and ambulances drives more fear than hope into the minds of patients. There should be a deliberate policy to widen the engagement of local groups in the fight to educate and teach the community leaders and their cohorts and this should be backed up with adequate resources.
To engender a robust approach to community engagement means that those who are local to the situation must be supported to deal with the issues raised by the spread of Ebola in a way that enriches their capacity and sustains their involvement at a par level with those who are otherwise resourced to come into an area but with inordinate ignorance.
The dynamics of engagement and community participation has been proven to be more effective when those who are closest to the problem are engaged as partners rather than as passive onlookers. To constrain the flow of resources on the pretext of a misconception of ability to account for these funds would be unsustainable. The transfer of skills that these people would bring to the table would be better accounted for by the increased monitoring and probity measures that may need to be put in place.
While these contexts remain, the pretext of political disagreement or grandstanding is really not helpful. The focus should be on shifting the burden of Ebola away from the sub-region and the experience of swarming that the Americans demonstrated in Liberia comes to mind at this stage. The policy should be to deliberately swarm the North and the Western Area with expertise and community activists, enable these cohorts to attack every household with vigour, to spread knowledge and information so that the communities learn the rudiments of dealing with Ebola within the shortest possible time. That the South and East of the country are faster learners is now becoming even more evident.
There is now a responsibility on Sierra Leoneans to focus on what bleak future we now face as a country. To digress from such pragmatic considerations in favour of political brinksmanship is the greatest disservice that political pundits, commentators and aspiring leaders can do to this country. This is not the time to expound on game saving strategies or scandalous profligacy. To give currency to such misadvised forays is unhelpful hence the deliberate attempt here to steer clear from specifics.
The general thrust is for those who can influence communities or resources to concentrate on pushing for the end game on Ebola with one voice. There must be an attempt to widen participation by bringing in the communities without further prevarication and consider every intervention as integrative rather than duplicating things.
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