Drastic actions in Sierra Leone

To control the spread of the Ebola epidemic, the government has imposed a four-day nationwide curfew: From September 18 to 21, 7,000 teams of three people each are supposed to visit all households. The teams will consist of staff from the Ministry of Health, aid organizations and trained volunteers to track down (hidden) Ebola infected people, provide education and show people how to protect themselves from infection. Prevention is the focus of this campaign. Thus, the Minister of Information emphasizes that the aim is to protect the population: After all, only 0.02 percent of the people have been infected. 5,999,000 people are not affected. It is important to protect them through prevention. For example, the distribution of soap to all families should be part of the home visits. Finally, this campaign is intended to strengthen the fragile trust in the Ministry of Health.

Without doubt, protecting people through education and hygiene measures is the most important step and long overdue. But this concept – if it can be implemented at all, it will still require 21,000 people to carry out home visits – has its pitfalls: Experts warn that more people could become infected in the narrowness of “home isolation”. If infected people are found, they must be quarantined immediately – but there are not nearly enough treatment centres and free beds in isolation wards in the country.

The backlog is already having an effect: Recently reported suspected cases could not be picked up and had to stay in their homes or on the streets for several days. The local authorities are considering the possibility of converting public buildings such as schools into isolation wards to prevent the imminent collapse. But basically, this idea is misleading, as neither the logistical effort nor the specific preventive standards can be met. There is also no solution to the lack of medical personnel; there are simply no doctors and nurses to treat the many new patients. In addition, the medical staff is extremely insecure. The lack of training and experience in screening and handling infected persons poses enormous safety risks.

It is to be hoped that the home visits do not primarily fuel people’s distrust of each other and lead to sick family members being even more likely to be hidden for fear of stigmatization. Because the visits are also intended to sensitize people to their own neighbourhood environment, so that Ebola sufferers will soon be reported to the Ministry of Health more quickly.

In addition, the four-day curfew also poses a major challenge for most Sierra Leonians, as the majority of them lives from day to day and have to find food every day. It is hardly possible to provide for four days of curfew due to the lack of cooling facilities. On the other hand, everyone who can afford it has already started hoarding food. In this already tense situation this could lead to riots.

In order to defuse the situation in Freetown, our team of social workers around Ole Hengelbrock has organized the supply of food for the children living on the streets for this period. On all four days of curfew, the team will cook for about 150 children each and distribute food to the street children. The special permit for this has already been granted. “The sleeping places of most of the children are known to us,” says Ole Hengelbrock. “Nevertheless, we are now walking through the streets every night to scour every corner of the area. We inform the children that they should not go outside during curfew but should stay in their places. On the one hand to bring them food, on the other hand to avoid trouble with the police and the military. Because there is an enormous potential for violence in an unwanted encounter. The soldiers will patrol. But those who are hungry take every risk. To prevent an escalation, we are already in close contact with the local authorities, point out the extreme situation of street children and offer our active help during curfew. In addition, we also provide food for elderly people living on the street and people with disabilities, as otherwise they would only make ends meet by begging. The task is big, but we are happy to be able to accomplish it. “