Policies that hinder and help...

New policies via the GoSL... as of January 23. 

I find it strange that in the UNMEER and NERC progress report of January 12-18, it states, "Many businesses are reporting an average of 40% drop in revenue since July/August, according to a new World Bank study." And it goes on to state, "Movements of EVD-suspected people across districts and chiefdoms are impeding effective surveillance." 

It seems the new policies, extending shop openings from 12:00 noon (on Saturdays) to 6:00pm, Monday to Saturday do little to help the economic crisis... But then... they lift a policy that was meant to help eliminate Ebola by limiting travel between districts. This seems to go against the advice in the UNMEER/NERC report.

What should have happened was to extend the shop openings till 9:00pm, Monday-Saturday... and keep the travel restrictions. (in my humble opinion)

Did you hear??? The number of Ebola Virus Disease cases has fallen in Sierra Leone.

That’s good news… welcome news… But, by all indications, there’s a long, long way to go.

Here’s some interesting tidbits of information from an UNMEER report of January 12-18, 2015.

In Sierra Leone World Food Program (WFP) is supporting 102 Ebola Virus Disease (EVD) health facilities including treatment centers, holding centers, and Community Care Centers (CCC).

Between 7th-19th January, 19,673 Ebola Response Workers (ERWs) were paid through mobile money. Of these, 96% have cash-out their pay.

The U.K. is supporting a total of 640 operational treatment beds across the country in Community Care Centers (CCCs) and Ebola Treatment Centers (ETCs).

Many businesses are reporting an average of 40% drop in revenue since July/August, according to a new World Bank study.

The Western Area (which includes the capital, Freetown) represented 40% (10% decrease from last week’s reporting period) of confirmed cases in this reporting period.

Each of these health facilities is to be managed and staffed by Foreign Medical Teams (FMTs, composed of 25-35 clinical and infectious disease experts) as well as national staff (200-250 required per facility).

The number of Ebola Treatment Centres (ETCs) remains the same as the previous reporting period. 23 ETCs are operational with approximately 1,174 current available beds, and total bed capacity of 1,693. There are 3 ETCs in the Eastern province, 2 in the Southern province, 6 in the Northern province and 12 in the western province. They are run by the MoHS, U.K, Médecins Sans Frontières, Save the Children, China, IFRC, Plan International, GOAL, Partners in Health, and other partners.

As of 11th January, there are 52 operational CCCs with approximately 528 current available beds, and total bed capacity of 530.

Since 17 November, UNICEF-supported CCCs have triaged 1,541 patients and admitted 237 patients across 5 districts. The number of patients triaged at UNICEF-supported CCCs has increased by more than 50% since early December. Furthermore, the most recent data demonstrates a 37% increase in the number of patients seeking care less than 48 hours after the onset of symptoms.

Movements of EVD-suspected people across districts and chiefdoms are impeding effective surveillance.

13 laboratories nationwide are operating with a total capacity of approximately 200-700 samples per day. There are 6 laboratories in Western Area, 3 in Northern Province, and 2 each in Eastern and Southern provinces. The US CDC, South Africa, Italy, Nigeria, Canada, UK, Netherland and China run these laboratories.

There are currently 125 burial teams operational in the country, conducting more than 190 EVD-confirmed or suspected burials/day. At a national level, Sierra Leone has sufficient capacity to safely bury all reported deaths. However, under-reporting of deaths during the outbreak impede 100% of safe and dignified burials.

Unsafe burials, including the washing of dead bodies, late reporting and lack of isolation continue to be the major factors in the high rates of transmission across the country, especially in Freetown and in rural areas.

Reporting from districts continues to remain a challenge. Half of the districts continue to fail to report their activities/reach to the pillar, impeding coordination and monitoring.

Observational Interim Care Centres (OICCs) are to be placed in each district (14) for children who have been in contact with an EVD-infected person so they can be closely monitored for 21 days.

There are 13 functioning OICCs covering 12 districts with a total capacity of 262 beds across the country. The OICC provide care for contact children with no caregivers. For the week 8th–12th January, 86 contact children were at the OICCs: Port Loko district with 22 children, Bo district with 21 children, Kono district with 17 children, followed by Moyamba and Bombali each with 7 children, and Kenema and Western Urban with 6 children. Cumulatively 193 children have been admitted in OICCs so far. These OICCs are managed by MSWGCA and supported by the UNICEF

MSWGCA/UNICEF and partners documented 492 additional children during the period 1st–12th January as being affected by the Ebola Virus Disease. Of this number, 421 children (199 boys and 222 girls) are in quarantine in their homes as a result of exposure to an infected person. Eighteen were confirmed to be Ebola positive (9 boys and 9 girls).

The cumulative number of children documented by UNICEF through the Family Tracing and Reunification (FTR) network is 15,258 (7,594 boys and 7,664 girls) of which 7,968 (3,985 boys / 3,983 girls) have lost one or both parents and 552 (253 boys / 299 girls) are unaccompanied.

Strikes and tensions continue to be reported across the country due to lack of clarity and harmonization on payments and incentives. Better communication on cash payments needs to be established with targeted workers so they know what to expect, when to expect it and how to submit questions and/or complaints. Additionally, monitoring mechanisms need to be reinforced to avoid double payments and ghost workers. Hazard pay system needs to be monitored to ensure accessibility and transparency across the country.

Bearing Witness - with the Globe and Mail

This is the piece from the Globe and Mail. They did a special section called, "Bearing Witness", marking the end of 2014.

http://www.theglobeandmail.com/news/stephen-douglas-how-ebola-had-tainted-the-culture-of-sierra-leone/article22181488/

How Ebola robs people of their right to mourn

STEPHEN DOUGLAS

FREETOWN, SIERRA LEONE — Special to The Globe and Mail

Published Tuesday, Dec. 23 2014, 1:29 PM EST

Last updated Monday, Dec. 29 2014, 3:47 PM EST

Bearing Witness: 2014 — The Globe and Mail looks back on the cataclysmic news events of 2014 through the eyes of the people who were there – be they bystanders, participants or journalists. Their accounts shaped our perceptions, while their witnessing the events changed their lives.

The smells were overwhelming yet familiar. As I parked my little motorbike across from the Kingtom Cemetery, the tropical West African breezes bore only chlorine, garbage and exhaust fumes. There was no sweetness in the air. Ebola, and its devastating consequences, had settled over the land and polluted the breezes.

According to the World Health Organization on Dec. 7, there were 1,768 dead and 7,897 confirmed, probable or suspected cases of Ebola in Sierra Leone. Freetown, the capital and crowded home to just under a million, regularly records one-third of all new cases, making it the epicentre of the disease.

Ebola has ravaged Sierra Leone. It has infected people. It has killed people. It has wiped out families. It has orphaned children. It has killed doctors, nurses and health-care workers. It has tainted the social fabric of the normally friendly and open Sierra Leone that I know.

My first visit to the Kingtom Cemetery was several years ago when I attended a friend’s funeral. It was a sad event. My second visit, this past August, was sad for a different reason. I was mourning for a nation. As I strode the well-worn community path through the cemetery to the Ebola section, I could feel my throat tightening. It was the fumes combined with fear and frustration. The tightening grip of Ebola is choking Sierra Leone.

The caravan of dilapidated minivans deposited the dead. Some of the vans carried as many as seven black or white body bags soaked in chlorine. As one minivan emerged from the cemetery trail, another entered. The procession of Ebola dead seemed to be unending. Abdul Rahman, the cemetery caretaker, continually warned me not to touch anything and not to let anything touch me. He also warned me to keep watch for snakes and avoid the wild pigs roaming the outer border of jungle.

Originally, I remember thinking how lovely the huge cotton trees were rising out of the dense green foliage of ferns and mini-palms. On this, my second visit to the cemetery, much of the jungle had been hacked away to make room for the graves of people who had died from Ebola. Freshly covered graves, open graves and crowded mounds of dirt replaced the giant fern leaves. The moist, warm intimacy of the rainforest had left.

White-suited, protected burial teams hauled the body bags, some obviously containing small children, across the bumpy mounds of the recently buried. In some graves, the larger body bags were buried with the smaller ones. According to Edison Konteh, one of the burial-team leaders, they’d picked up an entire family from a nearby neighbourhood. There was no one to attend the funeral. No prayers or biblical readings were recited as dirt was backfilled over the bodies by the shirtless, young gravediggers.

I remember Abdul Rahman saying, “This is not our culture,” referring to the lack of family members at the graveside. True. Sierra Leoneans celebrate and mourn when someone dies. I’ve been to enough funerals over my five years in Sierra Leone to know.

When I visited the Kingtom Cemetery a third time in October, the graves were crudely demarcated by a small branch of palm placed unceremoniously by one of the gravediggers. It was an attempt to mark and memorialize the graves. I thought the gesture was very kind. But a gravedigger reminded me, “There will be no mourning here because we don’t know who’s in the graves.” At the time, there were no adequate records beyond Abdul Rahman’s hand-written notebook of who was collected, unloaded and buried.

At the end of November, I visited the Kingtom Cemetery again. Abdul Rahman looked tired. The gravediggers had new rubber boots. Some of the graves had scraps of paper stuck to the palm leaves indicating the names of those buried. The Ebola section had grown and the jungle was almost completely hacked away. I didn’t see any pigs but the scattered graves seemed to go on and on. The caretaker told me they’d buried almost 3,000 bodies since July. I could see no mourners but the line of minivans delivering bodies was just as long if not longer.

And the smell … the smell was the same. Chlorine, exhaust and sadness hung in the air, choking the life from the country.

Stephen Douglas is a media-development consultant and journalist based in Freetown, Sierra Leone.