Dy­ing to live...

Financial Mirror (Cyprus) - - FRONT PAGE -

I was a young med­i­cal of­fi­cer work­ing at the Emer­gency Unit of the Ola Dur­ing Chil­dren’s Hos­pi­tal in Sierra Leone when I ad­vised the mother of a child with se­vere malaria to tell a bla­tant lie. Her daugh­ter Mariama needed a life-sav­ing blood trans­fu­sion. But her mother had no money to pay for the screen­ing tests and to com­pen­sate the blood donor. I had seen many chil­dren die while their par­ents fran­ti­cally sought the nec­es­sary funds.

De­ter­mined to save Mariama’s life, I told her mother to go home and an­nounce the death of her daugh­ter. I knew this would pro­voke the sym­pa­thy of her rel­a­tives, and they would scrape to­gether their mea­ger re­sources to en­sure a proper fu­neral. The mother agreed, and when she re­turned six hours later, she threw enough money on the ta­ble to cover all of Mariama’s care: a blood trans­fu­sion and treat­ment for malaria and worm in­fes­ta­tion. A few days later, I dis­charged the still weak but re­cov­er­ing four-year-old from the hos­pi­tal.

Though Mariama’s ill­ness did not move her rel­a­tives to ac­tion, her death did. The same thing hap­pened, on a much larger scale, dur­ing the Ebola epi­demic in West Africa.

It is be­lieved that the epi­demic first took hold in the forested re­gions of Guinea in De­cem­ber 2013, then grad­u­ally spread into Sierra Leone and Liberia. The in­ter­na­tional com­mu­nity watched as the dis­ease rav­aged the three coun­tries, dec­i­mat­ing vil­lages, wip­ing out en­tire fam­i­lies, and bring­ing economies to a stand­still. But, at the start, it at­tracted lit­tle at­ten­tion. The in­ter­na­tional com­mu­nity was con­tent to ig­nore the truth, un­til the epi­demic had be­come so wide­spread that they no longer could. By then, how­ever, it was too late to avert a ma­jor catas­tro­phe.

We are still learn­ing the full ex­tent of the Ebola dis­as­ter in West Africa. For fear of catch­ing the dis­ease, schools were closed, with stu­dents and teach­ers stay­ing at home. In­deed, many work­ers stayed home as well, caus­ing restau­rants, bars, and ho­tels to cease func­tion­ing and the econ­omy to grind to a halt. Half of all pri­vate-sec­tor jobs were lost. Farm­ers’ self­iso­la­tion led to a 30% drop in agri­cul­tural out­put.

Peo­ple’s so­cial lives stalled as well. A cur­few was im­posed in many dis­tricts, and longdis­tance travel was dis­cour­aged. In sev­eral towns, ac­cept­ing a visi­tor into your home meant the risk of a heavy fine.

Nonethe­less, the dis­ease spread into ur­ban ar­eas and, like a wild­fire, en­gulfed the three coun­tries and spilled into oth­ers. To date, more than 8,500 in­fec­tions and 3,500 deaths have been re­ported just in Sierra Leone.

The health sec­tor has per­haps been the hard­est hit. The death of more than 220 health-care work­ers left only 3.4 skilled health per­son­nel for ev­ery 10,000 cit­i­zens. As fear of Ebola mounted, many cit­i­zens stopped us­ing health ser­vices, re­flected in a 23% drop in births in hos­pi­tals or clin­ics, a 21% drop in chil­dren re­ceiv­ing ba­sic im­mu­ni­sa­tion, and a 39% drop in chil­dren treated for malaria. As a re­sult, these coun­tries ex­pe­ri­enced a resur­gence in vac­cine-pre­ventable dis­eases, malaria, ma­ter­nal and child deaths, and acute malnutrition. In this sense, the worst may be yet to come.

But Sierra Leone is pick­ing up the pieces, and has em­barked on a two-year re­cov­ery plan. The first pri­or­ity is to get the num­ber of Ebola cases to zero and keep it there. This means chang­ing the con­di­tions that al­lowed it to spread so rapidly in the first place.

The first step is to re­build the health-care sys­tem. The plan de­mands the restora­tion of health-care ser­vices in 40 hos­pi­tals and 1,300 pri­mary health-care fa­cil­i­ties across the coun­try, so that chil­dren and moth­ers can re­ceive free es­sen­tial care, vac­ci­na­tions, and treat­ment for dis­eases like tu­ber­cu­lo­sis, HIV/AIDS, and malaria. More­over, in or­der to bol­ster safety – and re­store con­fi­dence – in the health-care sys­tem, the plan calls for bet­ter in­fec­tion-con­trol prac­tices and train­ing for a new cadre of skilled work­ers. And it in­cludes closer co­op­er­a­tion with com­mu­nity groups, which should be en­gaged in dis­ease sur­veil­lance and re­sponse.

The post-Ebola re­cov­ery will not be quick, easy, or cheap. In Sierra Leone alone, it is ex­pected to cost $1.3 bln – $896.2 mln of which has yet to be pro­cured. To close that gap, we need help from our African part­ners and the broader in­ter­na­tional com­mu­nity.

Many years ago, with­out the help of a lie, Mariama would have died. To­day, we do not need lies. We need gen­uine en­gage­ment, open com­mu­ni­ca­tion, and mu­tual ac­count­abil­ity, at the lo­cal, na­tional, re­gional, and global lev­els. We have al­ready seen how a lack of es­sen­tial healthcare ser­vices can dev­as­tate a coun­try, tak­ing thou­sands of lives and shat­ter­ing many more.

We came to­gether as a coun­try to beat Ebola, and we are com­mit­ted to pre­vent fu­ture epi­demics. With on­go­ing in­ter­na­tional sup­port, we will do just that.

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