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PHM Sierra Leone comments on the Ebola Crisis

From Gabriel Madiye
The Shepherd's Hospice

Thank you for inviting some thoughts on Ebola epidemic in West Africa. It is a very serious problem that has claimed lives of health care workers; and we have our staff working to provide care in the field. We have had to temporarily close one of our community health centres in Mopala , Moyamba district of Sierra Leone. The Health facility has been serving a catchment population of 20,000 people providing primary health care and palliative care. However, we have recalled our staff to Freetown, capital city where universal precaution standards are better. They are working in the community palliative care program that treats pain and other distressing symptoms in patients with life-threatening illnesses such as cancer, TB and HIV. But our trained community volunteers in Mopala have been trained to identify the early signs and symptoms of ebola and report to the District Ebola taskforce for action. At national level  we are working with District Health Management teams to advocate for strict adherence to universal precautions by health workers. We advocate further that universal precaution must not only be implemented as an infection control measure in the health service, but it must be enforced by managers. 2000 copies of posters on Universal precaution are printed with funding from Bread for the World, Germany and European Union to distribute to health facilities. We are working with volunteers to report cases of patient care by Health workers who are treating patients in their homes. To this end we have placed neighborhood watch volunteers to report such persons to the appropriate authorities. At the moment we are implementing a health policy monitoring project  that trains health workers and community leaders to increase access to the Free health care for pregnant , lactating women  and under-five children. Ebola prevention and universal precaution has been integrated into this action to prevention transmission in the health service and the community.  But national ebola response remains to be championed by MoHS, WHO ,  MSF , Sierra Leone Red Cross and other development partners.
One small contribution made by the Shepherd’s Hospice is the assigning of a British volunteer nurse, William Frank Pooley, to the ebola care ward in Kenema . William has been in Sierra Leone to provide palliative care but opted to join the ebola effort when it was clear that local health workers were running away from health facilities that were treating ebola patients.  He is now helping in a situation where local health workers are fearful of patient care. Please I will be grateful for your support in any kind and measure as circles of people’s health movement.

About cultural issues , people in this part of Africa respect their dead , washing and dressing them, carrying corpses shoulder high and sleeping with corpses in the same room. They also leave corpses in the mosque on the floor where the congregation sits and pray. Leakages from the dead on the floor can stay even when corpse is removed. These traditional believe must be changed. But Government of Sierra Leone is already doing something. A state of public health emergency has been declared, suspending some civil liberties. Now large meetings and traditional burials are suspended. All suspects are reported and traced so that they could be isolated if necessary. But PHM may need to take some action to support the regional efforts.

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