Ebola: more should have been done, sooner


Charity Concern’s country director in Sierra Leone, Fiona McLysaght, tells Shelley Marsden why she believes a failure to act immediately has allowed Africa’s Ebola epidemic to become its worst yet

Concern Worldwide’s Country head of operations in Freetown, in Sierra Leone – one of the epicentres of the current Ebola crisis is Fiona McLysaght from Tuamgraney, County Clare.

Fiona worked in Sierra Leone during its civil war fifteen years ago. The current climate is equally alarming, but for a different reason – Ebola. The virus, which currently has no vaccine developed in Guinea in March this year and has since spread to Sierra Leone, Liberia and Mali.

Distribution of hygiene kits & protective products  (2)Ebola has killed over 220 people in Sierra Leone, and there are 631 reported cases. With numbers increasing all the time, the crisis is still at its height and, for Fiona the key issue is why it took so long it took to get a country-wide action plan in place.

“The first cases of ebola were identified in March. If more action had been taken at that stage, we might not be in the midst of a crisis. What happened for months was denial – pure denial that ebola even existed. That it is a serious issue is accepted, but it’s too little, too late”, she says.

“It’s spread throughout countries, into densely populated capital cities. This is very different to how outbreaks of ebola have happened in the past. Usually, you’d get a smaller-scale outbreak for maybe a month and it burns itself out. It’s staggering to me that in Sierra Leone alone we have over 630 cases”, she explains.

“We’ve had to switch from long-term development to emergency programmes, focusing every effort on ebola. If we don’t tackle this, it will undermine everything – state security, the health and education systems, the country’s economic development. Even when the situation does stabilise, there’ll be huge amounts of rehabilitation work to be done. It will set this country back a lot, as it will with the others affected. Either way, it will be devastating.”

Fiona and her staff are focused on mass awareness-raising on ebola in Freetown and Tonkolili where Concern has bases, and are busy distributing vital items like gloves, chlorine and hygiene kits to health care centres across the province and liase with frontline health-workers who they are training on ebola.

One of their biggest challenges, she reveals, is quelling the fear and keeping things in perspective. Though Ebola is a serious highly infectious illness with no cure, it is also preventable with simple measures.

Says Fiona: “If somebody is exhibiting symptoms, they should be taken to a health care facility as soon as possible. It’s transmitted through bodily fluids from infected people, but also infected animals – the host is a fruit bat and there’s a big culture here of eating bush meat, so we’re reminding people not to eat bush-meat under any circumstances.

“Also, those most at risk are the frontline healthcare staff, a lot of them have become infected. Part of our work is to protect them with protective clothing – gloves, aprons, masks. Then when they’re treating sick people, who we can isolate properly in any health care centre, it’s a whole different can of worms; they need the full protective equipment.”

They are also encouraging people to stop indulging in the traditional handshake – it’s not like it is easily contracted this way, but the fact of not doing it keeps the need to stay vigilant at the forefront of everyone’s mind.

What of those who recover from ebola and are discharged (to date, over 160 people)? If someone seeks medical treatment early, and has a good liver immunity, says Fiona, it is possible.Distribution of hygiene kits & protective products  (3)

“Part of our advocacy work is to ensure that these people get a post-recovery set up kit – a lot of their clothes, basic items; maybe even their house has been contaminated and subsequently burnt, so they can’t go back. There’s social stigma, so it’s important that these people are helped and not discriminated against.”

The country’s already compromised health system, she says, is creaking under the weight of the ebola outbreak, and Fiona has seen for herself how people are so terrified that they are staying at home and not seeking medical attention for other issues: antenatal care for pregnant women, children with potentially serious illnesses such as pneumonia, measles.

This in turn, says Fiona, will cause another big problem. Sierra Leone has one of the highest levels of child mortality. One in six children die before 5, and there are a high number of maternal deaths, so part of their mission is to get people back into health centres, and away from traditional healers.

People who have Ebola, or are exhibiting symptoms, are also very frightened, she tells me. They’re afraid – and they’d be right – that they will be immediately isolated from their family. Normally, a sick person has family members around comforting them. With ebola, you are whisked away, completely alone.

Though it’s important to help keep the local population calm, it’s not easy for people to go about their daily lives like before, says Fiona. You don’t see people walking around the streets like before, due to the number of government restrictions in place.

A state of emergency was issued by the President, and there are was a “lockdown” day a few days ago, a chance for the government to put the army and police in place, in the real epicentres of the disease.  But subsequently, further restrictions have been introduced with places like nightclubs and cinemas all closed down. Motorbikes, too, aren’t allowed from 7 to 7 – as their drivers move through different townships – some of which could be contaminated – very freely, they are another potential health risk.

As for the hysteria surrounding ebola and its spread, which some international papers are doing little to assuage, Fiona is emphatic – it must be kept in perspective. She may be in one of the areas in the papers every day, but she doesn’t feel particularly at risk herself, and thus doesn’t think people on the other side of the world should.

“Let’s be clear here, the people most at risk are frontline healthcare staff, risking their lives to get this thing under control, and family members and carers of people who are infected. When somebody dies, the traditional custom is to wash the bodies by hand – and touching a body at that stage is very highly infectious”, she says.

“We’re desperately trying to change these ingrained practises. The other category is traditional healers; sick people are shunning modern medicine and going to them, so they’re very vulnerable. For somebody like myself, I feel ebola is low-risk – it’s not airborne, and we have very good chlorine hand-washing facilities and hygiene practises all over.”

Fiona McLysaght trained as a nurse at the Regional Hospital in Galway.  She has worked with Concern in Sudan, Ethiopia, Rwanda, Burundi, Afghanistan and Liberia and, although she hasn’t lived in Clare for over 22 years, she very much considers it ‘home’.

For more on Concern and its work, see www.concern.net.



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