Nearly five months after the virulent Ebola outbreak, the Sierra Leone Government and its international partners have embarked on a number of activities aimed at slowing down the infection rate, and ultimately defeating the virus.
The President declared a state of public health emergency in July, which among other things, restricted citizens’ rights to movement and assembly. The government has also diverted funds previously committed to development projects towards the fight against Ebola. Schools and colleges remain closed, whilemany communities have been isolated and quarantined. Many businesses have shut down, and the country itself has been effectively isolated by most countries across the globe.
As part of efforts to combat the virus, the government and other agencies have spent enormous resources to promote public awareness on Ebola. Parliamentarians and civil society groups have also been involved in public education campaigns. Although awareness levels about the virus have significantly increased (according to a recent report by Focus 1000 and its international partners), this has not immediately translated into a reduction in the infection rate. Our international partners, led by the UN World Health Organization, have embarked on massive international fund raising to help fight the virus in West Africa. The governments of the United Kingdom and United States of America have been quite supportive as well. Several initiatives have been developed to help stem the spread of the virus, and effective case management is a key part of the global anti-Ebola strategy.
One of the prevention strategies currently enforced by the government is quarantines. Once there is a suspected or confirmed case of Ebola in a house, the entire home is quarantined for a period of 21 days in order to be able to immediately respond to anyone showing symptoms of the virus and to prevent infected persons from spreading the virus. It basically gives the case management teams a head start in terms of response. While quarantine as a control measure is in itself controversial, it has, however, proved to be useful when effectively enforced. Hundreds of houses have been quarantined since the outbreak, but the rising infection rate has raised questions about its efficacy. To date, there have been 3,156 officially confirmed cases, with nearly 1,000 deaths.
These figures suggest that some things need to be done differently. Part of the problem, many citizens have complained, is because quarantined homes are not getting adequate supply of basic food and non-food items. There have been many reports of quarantined (and potentially infected) persons fleeing quarantines in search of food. Apart from those who flee quarantines because of inadequate supply of basic food items, many believe that families and communities are less likely to report suspected cases of Ebola out of fear that their homes will be quarantined. This provides some explanation of why some people engage in unsafe burials and home care giving. The slow response time or lack of response by the government’s case management system is well documented, and the fact that people have to worry about basic resources such as water is bound to discourage persons from reporting suspected cases.We cannot wish Ebola away. We have to defeat it. But, this cannot be done unless we are able to break the chain of transmission. And doing so would require, among other things, willingness by individuals and households to immediately report suspected cases and painstakingly respect the quarantine protocols. This will not happen unless we are increasingly providing needed support to quarantined households. Otherwise, people will continue to break the protocols of quarantines, while others cover up Ebola cases by undertaking unsafe burials and home care giving in order to avoid being quarantined. These practices can only increase the chances of infection.
To help break the chain of transmission, the United States Embassy in Sierra Leone in September, 2014 approved a $25,000 grant to the Center for Accountability and Rule of Law to provide food and non-food items to quarantined homes. The project was first of its kind since the outbreak both in terms of the quantity and nature of items donated to quarantined households. The items,worth Le116 million, were reduced into 103 parcels. Each parcel included a size able quantity of sugar, drinking water, onions, Maggie, tea bags, coffee, sardines, butter, tooth paste, soap, ‘gari’, milk, and baby food. It also included a blanket and a towel for each beneficiary. Ten separate parcels were prepared for each household, which included items meant to be shared among household members. The items included vegetable oil, ten bags of (50 kg) rice, lamps, torches, transistor radios, batteries, salt, cereals, pulses, cooking fuel, assorted board games, Ebola sensitization posters, and assorted learning materials. Note that the care package currently provided by the government and its partners does not include all of these items. Items like towel and blanket are critical to the safety of persons living in a quarantined home. It defeats the essence of quarantines and our prevention strategy if people are still sharing towels and blankets. The board games, learning materials and transistor radios (and batteries) were included to help inmates relax while waiting out the 21-day period.
The practical benefit of this donation is obvious, but the Center for Accountability and Rule of Law would prefer to focus more on the non-material value associated with the donation. It carries an important message to the government and its partners about the need to scale up support to both quarantined homes and isolated communities. Human beings treasure freedom, and to restrict one’s movement for 21 days without the needed support would almost certainly cause them serious emotional and physical problems. As unfortunate as it is for anyone to be quarantined, there are ways we can make the experience less traumatizing or agonizing.