Local perspective on Ebola in West Africa

August 12, 2014

I am a returned Peace Corps volunteer who taught at a school in Sierra Leone, West Africa. I lived in Kenema, a regional center in the far eastern part of the country, country, which is now being called an epicenter of the Ebola epidemic. Kenema’s district borders Liberia, where many more cases are present, and is not far from Guinea, where the West African epidemic began late last year.

On July 27 the Ministry of Health and Sanitation of Sierra Leone and WHO reported a cumulative total of 533 suspect and confirmed cases, and 233 reported fatal cases. It is a tragedy for Sierra Leone as a whole, as well as for Kenema, that now this poor land is in the West African vortex of troubled countries, and in the path of deadly infectious diseases, specifically Ebola.

Although I have not lived there for years I have kept in touch and had hoped to go back there one day. It is truly unfortunate that so many hopes of my students never materialized - the Kenema Technical Institute, where I taught, is now abandoned.

My experience with the local hospital in Kenema, where now the patients of this vicious disease are treated, may shed light on the difficulties facing this poor country. From the news coverage of the area, it appears that the Kenema hospital is in the same location where I received medical treatment following a scooter accident that left me with a deep gash in my leg.

The hospital was a one-floor building with one hallway with perhaps a half dozen treatment rooms on either side. I wanted to get a tetanus shot and have the wound cleaned and bandaged. It was obvious that sterility was not a prime concern, and although the nursing staff was helpful, it was scary to be treated there.

I was anxious to get out as fast as possible, and in fact, after receiving the tetanus shot, I didn’t wait for bandaging, but was taken back to the school campus where the students helped to clean and bind the wound. At that time, the facility was inadequate for the normal medical needs of that community. Now it is tragically understaffed and under-equipped for an epidemic of this lethal disease.

Sierra Leone was never a wealthy nation. It has diamonds in the eastern part of the country, but the people do not share in this wealth. Foreign companies do the mining, and the few locals that work for these companies earn only minimum incomes.

Sierra Leone should have been one of the world’s richest countries, being blessed with resources. However, it remains one of the world’s poorest. Wealth that diamonds should have brought is not evident, and Sierra Leone is still emerging from scars from the recent brutal Sierra Leone civil war, which was fuelled by illicit diamond trading. Revenue from mining has not been redistributed to benefit the larger population due to poor management of resources and unrealized potential revenue.

Outside the towns, the villages are small, and subsist on tiny farm plots. Schools are scarce, and not free beyond the elementary level. Average income is miniscule. Many of the people in the rural areas do not trust anyone outside their own environment, and this disease is so frightening, that they likely don’t know what to think. Imaging seeing foreign medical professionals dressed head to toe in white gowns. Rumors spread easily that these “technicians” are there to do mischief, rather than help.

From the time I was there till now, mistrust of the government has been common and the history of corruption is long standing. The mistrust doesn’t help to confine this disease. With a fatality rate as high as 90 percent, it is no wonder that the outbreak continues to spread.

The country is in trouble. It cannot afford to treat all the victims of this disease. It can ill afford to see the increase in number of cases and the increased fear among the populace.

I hope our government can help these people. But Sierra Leone’s government also needs to learn from this medical nightmare that it has to take responsibility for improving its inadequate health care system if future epidemics are to be avoided.

I would like to relate my experiences to anyone who wants another perspective. I also have a website with some photos of the country.

Philip Fretz


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