UNCOVERING MEDICAL CONDITIONS IN SIERRA LEONE.

By Dr Augustine Kamara MD MPH. Freetown Sierra Leone.

Its been nearly two months since I arrived in mama Salone, and I am glad it is possible for me to observe the health situation of the country. Visiting around various hospitals, and other health institutions, I feel disappointed that Sierra Leone is yet to move the health institution, and health workforce forward to an appreciable and acceptable standard.

If people are to survive with the least trivial of health problems, then it is a must that the health system be revamped as soon as possible. I visited several times the Connaught hospital the main government and referral hospital in the capital Freetown, I am appalled to see an Emergency Room (ER) that is lacking with the basic diagnostic tools let alone the personnel as one would expect to see in an ER. There is hardly any physician to be seen around the ER, and if one is present, it would be occasionally and briefly leaving the rest to be taken care of by few nurses. This is the reason why most patients would avoid this hospital, for other private hospitals like the Choithram hospital at hill station, Abanita hospital off kingerman road.

The very few that can afford it, would fly out of the country to India, neighboring Ghana, or Europe. The Chinese hospital at Jui the east end of Freetown, is a standard hospital with a robust medical staff, but again not many patients can afford to visit this hospital when they fall sick.

I visited a private hospital at mile 13 along the Freetown peninsula -Goderich axis, this is one example of a clinic created by diasporas that could change the face of the health condition in Sierra Leone; This is a small clinic that has some diagnostic material that caters for the catchment area around Goderich even though it is struggling for enough medical staffs. I have not been upcountry to see how things are done, but, one can easily conclude that things would not be better off than the capital city Freetown. At this juncture, I would advocate to fellow Sierra Leoneans with medical background to take the challenge as a few have done to come back and give service to their country.

I know it would not be easy to do that when one thinks about the hurdles one must overcome. The government of the new direction must help in this matter by encouraging health personnel from the diaspora to come back home. Diaspora must be ready to form partnership and build alliances like our Ghanaian counterparts have done in Ghana to alleviate the sufferings of not only Sierra Leoneans, but regionally. As part of the fight against corruption, let the idea of “2 sim” ideology segregation be abolished.

The idea of colleagues’ or senior officials in the medical profession, that tend to discourage medical professionals return from abroad, by discouraging their recruitment must be investigated into. I see no reason why medical personnel from other continents, and countries that have similar qualifications as Sierra Leoneans to be good salaries; but refuse to give the same salaries opportunities to Sierra Leonean doctors or nurses. I have gone around and can testify to this malpractice within the medical profession by senior officials. I guess we will not easily fill the gap of medical personnel without foreign help, but slowly we can bridge the gap of medical personnel shortage if we encourage “2 sims” to come home with good incentives, the same way the Ghanaians did. The brain drainage by our medical personnel will also be curtailed. It is high time we build strong medical institutions with meaningful faculties in our new form medical college.

Community medicine or Public Health must be put into good practice effect, by strong health education, and outreach activities. Our poor environmental sanitation, including food handling by peddlers, and daily practices of hygiene including hand washing is awful. These are the main sources of public health where intervention, and prevention must be done. We must have learnt why the Ebola Virus Disease “EVD” quickly disseminated within our communities was due to poor hygiene, health education, and lack of personal protective effects (PPE). After the last episode of the EVD in 2014 in West Africa, one would expect serious awareness preparedness for future unprecedented natural or artificial calamities should be going on. There must be drills of different public health awareness of the communities, organized at local, urban, and national levels. The different cultural and religious bodies must be involved as well as mass media; Schools, and colleges should be encouraged to partake as volunteers in serving their communities. Outreach activities should be double paced to educate the different populations.

Waterborne diseases including mosquitoes seem to be responsible for most of our common ailments, one can quickly say about 70% of our ailments are waterborne diseases. Recent years have expressed serious flooding along our coastal lines that affected low social economic status dwellers not only by displacing them from their poor habitats, but also impinged on them serious gastrointestinal diseases such as cholera outbreaks or typhoid. The soup created from unsanitary latrines during flooding would infect underground water, exposing the entire population to diseases such as typhoid, weils disease, and cholera. Stagnant water around the city in crevices, open tins and abandoned open containers, or disposed lorry or car tyres and abandoned water-pipes are good breeding grounds for mosquitoes; poor refuse disposals, and mines of dustbins are good breeding grounds for mosquitoes, rodents, cockroaches, stray dogs. The eradication by recycling of these dumping grounds, would greatly reduce illnesses such as Lassa fever another hemorrhagic disease caused by rats.

Over population is a major problem in Freetown, that creates a social menace. Apart from unemployment, there is high incidence of prostitution the scary cause of HIV infection upsurge that has engulfed the population according to reports from the media. Drug addiction and crime is on the rise among the youths, a partial creation by political parties who used the innocent unsuspecting youths to carry out violent campaigns during elections but left jobless after election periods.
The common man and some of our “pepe” doctors or quack doctors are quick to diagnose everyone as having typhoid, or malaria with non-laboratory/radiology diagnoses. The innocent population is tortured with frequent malarial medications, and saline infusions, that can easily be reached.
Constitutional or systemic diseases like Diabetes, Hypertension, Urinary Tract Infections etcetera, are often missed out or misdiagnosed or delayed due to lack of diagnostic tools. It is disheartening to think of a simple interpretation of an electrocardiogram (ECG/EKG) is done by few as two physicians in the entire nation. There are instances an EKG result must wait for it to be interpreted in Europe, or America until then nothing would be done to attempt a cure. This is just some of the simple things that are lacking.

However, there is an olive branch to be extended to all the brave Sierra Leoneans that withstood the test of times, and challenges; despite the shortcomings in the health system, they have been there to rescue as much as they could whether at Connaught or elsewhere. I must pause here for a minute of silence to recognize our fallen heroes during the EVD; this goes from Dr. Khan and all other medical personnel both nationals, and international players including volunteers that lost their lives in combating the deadly bug. As we move with the new direction of president Maada Bio, I humbly request the full participation of all Sierra Leoneans to drop all animosity or grudges we may Abor for one another and help propel the country forward.

When one considers the country’s potential wealth, Sierra Leone should be counted as one of the most progressive nations in the continent of Africa, and the world, but this will come only if we Sierra Leoneans think as one family, and embrace ourselves as brothers and sisters, and put the interest of the country first. Meanwhile I am humbly asking our government and all officials of the country to also be honest in running the country and to do due diligence in promoting the development of the country. PAOPA SALONE FOR BETTEH.

Cocorioko 5th September 2018

Sierra Leone News: Lack of access to clean water, toilets puts children’s education at risk

Millions of children are going to school without basic hygiene facilities, and the goal of universal access to basic water, sanitation and hygiene remains “a huge challenge,” the United Nations warned on Monday 27th August 2018.
A new joint UN agency study, Drinking Water, Sanitation and Hygiene in Schools: 2018 Global Baseline Report, said that good hygiene facilities in schools provide the basis of a healthy learning environment, and that girls are more likely to attend when they are on their period.
Moreover, children who pick up good hygiene habits at school can reinforce positive life-long behaviours in their homes and communities, said the report.
However, millions of children are going to school without basic hygiene facilities: over 30% of schools worldwide do not provide safe drinking water; a third of schools do not provide the most basic of toilet facilities such as septic tank, pit latrines or composting toilets and nearly 900 million children go to schools with no handwashing facilities with soap and water.
In Sierra Leone, the report noted, only 19.0% of people wash their hands with soap after contact with faeces; 66.3% wash with water only and 14.7% did not wash their hands at all. Their hand washing practices are poorer before contact with food with 10.2% washing their hands with water and soap, 48.3% with water only and 41.5% do not wash their hands at all.
In addition to the lack of WASH facilities, inconsistent access to soap is another of the big barriers. The study shows that approximately half of primary schools in the country have access to improved water supply and sanitation facilities. Despite the millions of dollars of donor funds through WASH activities, schools remain a hygiene disaster when it comes to children and handwashing.
However, the compliance to the national standards for WASH in schools is a big challenge, the report said. “ Only 9.5% of schools have improved water supply facilities up to the standards in their school compound. And half of them are not functional.”
The report concludes that 4.6% of primary schools meet the national standards in sanitation facilities adding that schoolchildren in 40.4% of surveyed schools practice open defecation in school and non-existence, unhygienic conditions of latrine and lack of privacy such as no doors are three leading causes of open defecation.
The annual report is produced by the World Health Organization/’UN Childrens Fund Joint Monitoring Programme, or JMP, which has been monitoring global progress on drinking water, sanitation and hygiene since 1990.
Commenting on the report, Kelly Ann Naylor, Global Chief of Water, Sanitation and Hygiene at UNICEF, said, “If education is the key to helping children escape poverty, access to water and sanitation is key to helping children safely maximize their education. To neglect this is to be careless with the well-being and health of children.”
Universal access to basic water, sanitation and hygiene in schools is part of the 2030 Agenda for Sustainable Development, but achieving this ambitious target presents a still huge challenge.
SV/28/8/18
By Sylvia Villa
Wednesday August 29, 2018.

Sierra Leone News: “Garbage-slide” buries metal scavenger

A wall of garbage collapsed in the morning of Thursday 23rd August 2018, trapping a metal collector in Granville Brook, just below the Kissy Road bomeh dump. Rescue attempts continued through Thursday and Friday with no success. Heavy rains on Saturday and Sunday hampered further recovery efforts. Persistent “garbage-slides” have continued to bury the body deeper under a growing sea of waste.
Abdul “Razor Blade” Bangura, a 27-year old father of one, is still missing and assumed to be the suspected victim in the collapsed garbage. His body is yet to be recovered but people living in the area, including his family, are certain that he is dead and buried under the trash.
The piles of trash rise up to 25-metres, as high as a three-storied building. The Granville Brook waterway flows through the dump site and runs between the towering cliffs of garbage through an informal community of thousands of people living in largely makeshift structures of zinc and sticks. The smell is overpowering. The decaying mountains of unsorted waste – hazardous and toxic – is a monumental disaster waiting to happen.
Officers from the Ross Road Police Station responded to the dumpsite on Thursday 23rd August 2018 and spoke to witnesses. Operations Police officer stated that the investigation of the accident is still ongoing and will likely be completed by the end of the week.
In August 2017, almost exactly a year ago, a 30-year old man was buried and killed in a similar “trash-flood”. According to the Police, two brothers were scavenging for metals when the cliffs of garbage shifted and fell. The avalanche of garbage and debris injured one brother and swept away the other resulting in his death.
Police have warned people and residents from venturing into the trash canyon but numerous people continue to scavenge, knee-deep in wastewater, panning for metals, in the shadow of the garbage-slide.
JR/8/28/18
By Jack Russillo
Awoko Wednesday August 29, 2018.

Sierra Leone News: Doctor in Eastern Congo contracts Ebola

A doctor has become the first probable Ebola case in one of the eastern Democratic Republic of Congo’s “high insecurity zones” which are dogged by militia violence and hard to access, a scenario “we have all been dreading,” the WHO said on Friday.
Since the outbreak erupted on August 1, 103 confirmed and probable cases of Ebola have been identified in North Kivu and Ituri provinces, including 63 deaths, the health ministry said in an overnight update.
The doctor living in Oicha town in North Kivu has been re-hospitalised with Ebola symptoms after his wife was confirmed as having the disease when she traveled to the nearby city of Beni, said Dr. Peter Salama, the World Health Organization’s head of emergency operations.
Oicha is almost entirely surrounded by ADF Ugandan Islamist militia, there are “extremely serious security concerns,” he said. Aid workers, priests and government officials are held hostage in the area, he said.
The doctor’s initial test for Ebola — which causes vomiting, fever and diarrhea — had been negative, but fresh results are awaited, said Salama.
So far 97 of the doctor’s contacts who may have been exposed to the virus have been identified, and vaccination has begun in the town, he added.
“So for the first time really we have a confirmed case and contacts in an area of very high insecurity. It really was the problem we were anticipating and the problem at same time that we were dreading,” Salama told a news briefing.
WHO and health experts reached Oicha with armed escort by MONUSCO troops this week, he said, adding: “We know from that incident now in Oicha we are going to have to operate in some very complex environments due to security and access concerns.”
In a further worrying development, angry youth burned down a health center in another village, where vaccinations were under way, after learning of a death from Ebola, Salama said.
More than 2,900 people have been vaccinated against Ebola since the outbreak began, he said.
“We are at quite a pivotal moment in this outbreak in terms of the evolution of the outbreak epidemiologically and in terms of the response,” he said.

Awoko Tuesday August 28, 2018.

Sierra Leone launches Free Quality Education for School going children

Freetown, 20 August 2018: Over 1.5 million school children are expected to benefit from the Free Quality School Education initiative at the start of the school year September.

This flagship initiative, launched today as part of the new Government’s initiative under the leadership of HE President Julius Maada Bio, will ensure increased access to government-assisted schools for all children from pre-primary to senior secondary levels across the country.

With support from donor partners including UK Aid, World Bank, Irish Aid, World Food Programme and UNICEF, this initiative will be phased over five years, and will waive the payment of tuition and admission fees and provision of teaching and learning materials with an initial emphasis on English language and Mathematics text books to all secondary schools in the country. It will also ensure that payment for public examination fees such as the National Primary School Examination (NPSE), Basic Education Certificate Examination (BECE) and West Africa Senior Secondary School Examination (WASSCE) are waived.

“The waiver of fees for learning in any form will definitely ease the burden on parents and guardians who are making a lot of sacrifices under extremely difficult economic conditions to see their children become educated,” said Hon Alpha Timbo, Minister of Basic and Senior Secondary Education.“ This initiative by our Government will no doubt increase educational outcomes and human resource capital will be  strengthened to meet the growing social and technological revolution in a globalized world.”

Parents are being encouraged to provide uniforms and some text books for a start and continue with their traditional role of home supervision, support and coaching to ensure they take maximum advantage of this opportunity.

“We are proud to be supporting the Government of Sierra Leone on this initiative,’ said Mary Hunt, Head of Office at DFID Sierra Leone. ‘I am really pleased to see the priority the Government is giving to ensuring all children –  girls, boys, those with disabilities –  throughout the country access quality education.”

A hotline (#4060 from any local network), is being set up to encourage pupils, parents and community stakeholders to report malpractices in schools and communities. The District Deputy Directors of Education, Ward Education Committees and paramount chiefs will also conduct rigorous monitoring in their localities.

“This is a laudable initiative by the Government of Sierra Leone and the commitment shown in increasing education budget from 12 to 21 per cent, will significantly increase access, improve quality and school completion in the coming years,” said Dr Hamid El-Bashir, UNICEF Representative in Sierra Leone. “UNICEF will continue to partner with the Ministry of Education and other stakeholders to ensure that this initiative yields the best results for children of Sierra Leone.”

As children return to school in September, it seems a brighter future awaits them.

Cocorioko 21st August 2018

Legal Aid Board Aborts Child Marriage At Lumley, Sierra LeoneS

Legal Aid Board Aborts Child Marriage At Lumley, Sierra Leone

10 August 2018: The Minister of Social Welfare, Gender and Children’s Affairs, Ms. Baindu Dassama, The Executive Director of the Legal Aid Board, Ms. Fatmata Claire Carlton-Hanciles and The Commissioner for the Children’s Commission, Ms. Laggah have in a joint press conference held in the Conference Room of the Lumley Police Station in Freetown on Friday, August 10 pledged to work together to ensure justice is served in the ongoing police investigations into the botched child marriage. (Photo: Police storm the mosque to stop the marriage)

The press conference follows the aborting of the marriage ceremony at the Fula Mosque in Grassfield, Lumley in the West of Freetown on Thursday, August 9 by staff of the Board and the Police. Ms. Dassama said since this is the first case of child marriage brought to her attention, she will do everything in her power and within the law to ensure it does not happen again.

She said she will be meeting with the Chief Justice to discuss the matter. She added that Sierra Leone is a country of laws and that the law will be followed to the letter. ‘I was surprised when I came to the police station yesterday and family members of the child bride were begging for forgiveness but this is a matter nobody can stop,’ she stressed.

In an interview with the child bride prior to the joint press conference, she said she is the second in the family of six children. She could not tell the age of her elder sister. Also, she could not tell when she got married. There is a strong feeling within the Board that the sister could be a victim of child marriage.

How did we get to this point? The Legal Aid Board office in Freetown was thrown into panic following a call from a partner in Grassfield, Lumley to Ms. Carlton-Hanciles at about 3:00 pm that a marriage ceremony was being planned for a girl child at the Fula Mosque at Grassfield, Lumley. According to the partner, the marriage ceremony was going to take place at 4 p.m. The source added that the child lives with her parents at Grassfield. She is a pupil of the Wesleyan Primary School in Lumley and sat this year’s National Primary School Examination (NPSE).

With this information, the Board was convinced the child is not above fourteen.  The Assistant Community Relations Officer of Board, Ben Turay who has an official motorbike was dispatched immediately to the area to keep an eye on the preparations and provide update to the office while the police were being mobilized. Ben got to the scene within fifteen minutes and confirmed worst fears that preparations were in top gear as almost two hundred guests had converged on an address at Grassfield for the ceremony.

The Board’s Public Relations Officer Mr. Derek Nat-George and Assistant were also dispatched to the scene. The Assistant should film the area from a distance. The six Paralegals in Freetown were also deployed in the area.

While the staff deployments were going on, Ms. Carlton-Hanciles contacted the Director of the Criminal Investigations Department (CID), Chief Superintendent Tommy to brief him on the matter and further requested that the police be dispatched to the mosque at Grassfield to arrest all those participating in the ceremony including the officiating Imam.

Ms. Carlton-Hanciles also called the Minister of Social Welfare to brief her on the matter and the action that was being taken by the Board. While all of this was going on, the partner continued to provide regular update on the preparations.

A staff of the Board, Mr. Algassimu Sesay was deployed at the Lumley Police station to provide update on the matter, assist with preparations for the raid and ensure it is given the priority it deserves. ‘We deployed a staff at the Lumley Police Station to ensure there is no room for excuses,’ Ms. Carlton-Hanciles.

When the stage was all set for the marriage, a team of police officers from the Lumley Police Station stormed the mosque and made four arrests. This includes bridegroom, Mamadu Alpha Jalloh who is twenty-seven and lives at Babadori, a male guest who obstructed the police, the bride’s mother, Fatmata Binta Barrie and a female guest who posed as the bride in an attempt to deceive the police.

Bridegroom Mamadu Alpha Jalloh

In a meeting with Detective Assistant Superintendent, Mustapha Gogra of Lumley Police Station on August 10, Ms. Carlton-Hanciles urged him to arrest the sick father and put him on bail. ‘The Father was aware of the marriage and consented to it,’ Ms. Carlton-Hanciles said. She also called for the arrest of the Imam and the others who officiated the marriage.

As the investigations commenced, Ms. Carlton-Hanciles deployed the Board’s Juvenile Lawyer, Mr. Joel Deen-Tarawally at the Lumley Police Station to provide legal assistance and also help the police with the proffering of charges.

The Minister of Social Welfare, Gender and Children Affairs, Ms. Baindu Dassama visited the Lumley police station in the evening of August 9 to lend weight to the ongoing investigations and to impress upon the police that justice must be done at all cost noting this is a test case for her Ministry.

Sierra Media Express 14th August 2018

As we remember August 14 victims… Sierra Leoneans vow to combat disaster

By Ranger

Yesterday, 14 August 2018 Sierra Leoneans at home and abroad remembered those who were struck by the twin disaster of mudslide and flooding a year ago. It was a gruelling and large scale national disaster that took precious lives and destroyed properties worth millions of Leones. As we recalled yesterday and from the various accounts we heard at Regent Village where the disaster occurred, it again dawned that indeed it was a sad moment in the history of our beloved country.

On that chilling morning, 14 August 2017, Freetown awoke to the shocking and sorrowful news of another major disaster brought about as a result of a torrential rain fall which caused a landslide and later flooding which left in its wake individual deaths and destruction of properties at Regent, Kaningo and other places.

The large scale horror which that disaster caused still continues to confound many, those affected directly and otherwise. Thousands of lives were taken by this calamitous human tragedy. Connaught hospital mortuary was over filled with dead bodies; most of them were not recognized. Weeping and wailing by surviving relatives evoked an atmosphere of sombreness almost leading to the running of tears.

Some have argued that before the twin disaster struck residents in the affected localities must have realized that they were risking their lives by dwelling in those places.

Indeed, there is an iota of truth that it is quite correct for people to have abstained from residing in disaster prone areas as they will definitely be exposed to danger.

Lamentably, some did not take the situation seriously by avoiding to do so simply because they were just too obsessed with living in Freetown. There are some who were displaced during the 11 year old war and came down to Freetown. However, since the war ended they refused to return to their places of origin but stubbornly decided to reside in Freetown even under risky conditions.

Others have been arguing that the Government should have long ago taken a very decisive action by preventing people from residing in disaster prone areas.

We have all learnt the bitter lesson that it is dangerous to be residing around the red belt zone.The argument has taken the dimension that people should be forcefully removed from those areas and relocated to other safer places. It is stressed that the Government and other stakeholders should take the cue from the previous incident and takes the necessary steps, devoid of sentiments, to deal with the situation which has now become a perennial one.

It is good that the current Minister of Lands Dr.Dennis Sandy has shown enthusiasm and commitment to remove all those who are residing in disaster prone areas saying they have no business to reside in those places.

The fact remains that the 14 August 2017 ugly episode must serve as a wakeup call on the part of Government and all to take positive strides by putting all the necessary parameters in place to prevent the future occurrence of a similar incident.

As there is a plan to make the disaster zone a historical and touristic site we must also be on our guard to combat those things that will plunge us into another calamity.

Relatedly, the issues the victims are raising bordering on crying foul of not getting the right treatments they claim they deserve must be critically looked into in order to find a lasting solution. However, they must not continue to bask in the notion that until eternity or thy Kingdom Come Government must continue to provide succour for them. Let us continue to remember them in our prayers.

Cocorioko 15th August 2018