Commentary
By Alhassan Fouard Kanu, Freetown, Sierra Leone.
The Ebola outbreak in Sierra Leone has provided rich research opportunities for scholars. There are many interesting areas to explore ranging from investigating determinants to exposure/contracting the virus to perspectives of survivors of Ebola.
The author is currently exploring the views of Ebola suspects and survivors with regards to the level of care provided in the isolation and treatment centres. The study is underway but because of the tormenting observations, the author thought it fit to bring out some of these observations to ensure that measures are instituted to enhance the survival rate in the Ebola suffering population.
Ebola has evoked considerable fear in the public including the carers (health workers). Coupled with the lack of protective gears, health workers are grappling with deep fear in interacting with Ebola patients and hence, compromise quality of care. The management of Ebola involves two centres, namely the isolation centres and the treatment centres. The isolation centres, which are almost in every district are meant to hold up persons considered suspects of the disease. These are individuals who have associated with a confirmed Ebola case or a deceased person. Holding these persons for 21 days is meant to detect signs/symptoms manifested by the suspects. With manifesting signs/symptoms, blood samples of these persons are taken to the laboratory, currently in Kenema and Lakka in Freetown. Should the result be positive, the persons are then moved to the treatment centres (Kenema and Kailahun at the moment). At the treatment centres, palliative care including psychosocial support is to be provided to the patients and many, through timely medical intervention, have survived the disease.
Observations from isolation centres are discouraging. Due to lack of space in some of the district hospitals, both males and females have to share the same ward. Health staff contact with these suspects is minimal because of lack of appropriate protective gears. Daily baths are scarce and appropriate beddings are sometimes lacking in some hold-up centres. As a measure to prevent Ebola suspects from sharing the same toilet facilities with other non-suspected patients, hold-up Ebola suspects use bed pans in the presence of others. Such treatment meted on the Ebola suspects and patients have huge psychological implications. Some of the Ebola patients probably died because of the neglect leading to loss of hope.
As we say kudos to the government and the newly appointed Minister of Health and Sanitation for responding to the clarion calls for appeasing measures to be instituted such as increase in salaries or provision of appreciable risk allowances for the health workers, it is equally our responsibility to implore health staff members to adhere to the Nightingale Pledge or Hippocratic Oath as appropriate. It behoves the health staff members to make a huge difference in their caring roles now that risk allowances have been provided. Today, our heath workers are the protectors/givers of life in the fight against the scourge but are reminded that they might also be the receivers (God forbid, it should never be for Ebola). Treating others with disrespect today means you will be treated as such some day. Ebola suspects or patients are not condemned prisoners and deserve to be treated with dignity like other patients.
An enabling environment must be provided in all health service delivery points to allow our health staff members or personnel to work fearlessly in their duty of caring for not only Ebola cases but for patients with other ailments. Tent or containerized isolation centres should be provided in all district hospitals. Using hospital wards heightens the fear of the populace on utilizing these facilities.
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