Face-to-face with Ebola: The lessons Kenya should learn from this crisis

From the distant forests and rolling hills of Guéckédou in South Western Guinea, the first echoes of the deadly sickness decimating families began to emerge in early 2014.

Nobody knew what was killing people. For a time, doctors and other health professionals were confounded. But few sicknesses kill entire families and anybody who comes in close contact with ill people. Soon, even doctors and nurses who had treated the patients were getting sick. Before long, tests confirmed that Ebola Virus Disease had broken out in Guinea.

In the following weeks, with undiagnosed sick people moving around, medical staff working without adequate protective gear and training, dead Ebola victims being inappropriately handled and some patients leaving hospitals against medical advice, the disease hit Liberia, Sierra Leone and Nigeria.

SPREAD WIDELY

Ebola, which had never before spread widely from the areas where it broke out, soon infected people in many places, including the heavily populated capital cities of Conakry, Monrovia, Freetown and Lagos.

The governments of the affected countries have pulled all stops to curb the spread of the virus but are handicapped by want of resources, personnel and facilities. Recently, in Sierra Leone, the government worked with the public, development organisations and volunteers for a three-day stay-at-home called ‘ose to ose tok’ in Creole, meaning ‘house to house talk’.

For those days, virtually every soul stayed indoors. Even the dogs that roam the streets of Freetown and the villages were scared of going out, wondering why the usually noisy city and hamlets were very quiet.

It is was a study in national obedience and recognition of the mortal danger, which Ebola represents, that all the people of Sierra Leone heeded the government request to stay home.

Nearly 30,000 healthcare workers, teachers and social mobilisation volunteers fanned out across the length and breadth of the land to teach people about prevention of Ebola and why they must go to hospital immediately if they are taken ill.

I imagined how a similar effort would not easily succeed in Kenya as some smart-ass litigant would rush to court to claim that his individual rights of movement and association trumped communal interests in public health.

Some Kenyan judge would then immediately pronounce an injunction to stop the stay-at-home order. By the time the court battles concluded, the virus would have spread further.

In Guinea, where this outbreak began nearly a year ago, some people still do not believe Ebola is real and are hostile to health care and social mobilisation workers.

Recently, reports emerged of villagers killing eight members of a team who had visited to raise awareness about the disease near the city of Nzerekore.

Ebola has created heroes, with brave doctors, nurses, laboratory technicians, epidemiologists, ambulance drivers and burial attendants taking huge risks, sometimes with inadequate protection and modest pay.

Dr Sheik Umar Khan, Dr Modupe Cole, Dr Sahr Rogers and many nurses, for example, caught the illness from patients have died. In Nigeria, Dr Ameyo Adadevoh, several nurses and staff at the First Consultants Medical Centre in Lagos died when they contracted Ebola while treating a patient from Liberia.

In a sad illustration of how evil Ebola is, a nurse called Justina Ejelonu, who was pregnant, contracted the virus on her very first day at work in that health facility and later died.

Before Ebola broke out, cities and towns in West Africa were a beehive of activity, with markets full of food, traditional clothing, artworks and trinkets vying for space with manufactured Chinese goods.

Motorcycles, also known as ‘okada’ and ridden by young men, zoomed around town day and night, competing with taxis for passengers. New roads were coming up, easing traffic congestion. Poverty was beginning to fall as the economies grew. Agricultural production was on the rise.

Sierra Leone, Guinea and Liberia are some of the most endowed places on earth with copious amounts of rainfall, fertile soils, shoals of fish in the Atlantic and massive deposits of iron ore, rutile and diamonds. Nigeria has its huge oil reserves and entrepreneurial people.

WAKE-UP CALL

The Ebola crisis is a wake-up call to use these resources better in future, especially by investing more in healthcare, education, infrastructure, disaster preparedness and social services.

Ebola made some people and countries to leave Sierra Leone, Guinea and Liberia to their own devices, which is not helpful. If the people and governments of the affected countries ever needed help, the time is now. As they say, ‘a friend in need is a friend indeed’.

Countries should reopen their borders and allow flights and trade to resume while strengthening their preparedness to address any Ebola outbreaks.

Closing borders is counter-productive as it makes the affected countries less able to get essential supplies, personnel, food and other necessities, which then increases infections and makes it more difficult to contain Ebola.

If Ebola is not contained soon, inflation could accelerate in the coming months due to shortage of food and other supplies. Local currencies will depreciate as foreign exchange reserves decline because of uncertainty, capital flight and a fall in exports.

This will exacerbate inflation due to the high dependency on imports in the region. The World Bank estimates the short-term impact of Ebola on Gross Domestic Product (GDP) to be a decline in growth of 2.1 percentage points in Guinea, 3.4 percentage points in Liberia and 3.3 percentage points in Sierra Leone.

This lost output would amount to US$359 million in 2014 prices for the three countries. However, if Ebola is not contained soon, the lost output in the medium-term would amount to US$809 million in the three countries.

Ebola is a major crisis that will severely test the economies and public health systems of the affected countries and have repercussions throughout West Africa.

There is a great need to increase the international efforts to provide treatment facilities, protective gear for health workers, food supplies for families in quarantined areas as well as educating people on how to prevent and eliminate the Ebola Virus Disease.

LARGE CONTRIBUTIONS

Large contributions by the World Bank, the Bill and Melinda Gates Foundation, the US and China, among others, are commendable. For instance, the World Bank announced on September 25, 2014 that it was increasing its Ebola response funding to a total of US$400 million.

Other donors and nations should step up their support to stop this great calamity. And the funds and supplies should be used prudently to provide adequate health facilities and supplies to treat patients, and to prevent the spread of Ebola.

Despite this tragedy, Ebola may set a stage where the valuable lessons learnt on how to manage such a profound public health crisis, and its cultural, social and economic consequences, translates into improved investment in healthcare, education, social services, infrastructure and better preparation for future crises.

Sisule is a Kenyan working in West Africa. Email: [email protected]