In the twilight of the first half of 2014, Sierra Leone was hit for the first time by the Ebola virus, unknown to its people and healthcare. Sierra Leone was not the only country assailed by the mysterious virus. Other West African nations of Liberia, Guinea and Nigeria also recorded cases of the virus. There were more than 30,000 recorded cases of infections and a total of about half of those cases succumbed to the virus in the said West African nations. It took Sierra Leone more than a year and half plus loss of about 4,000 of its people to get to zero infection from the inception of the outbreak. Experts and activists opined that very weak health infrastructures combined with its then ailing economy accounted for Sierra Leone’s highest recorded deaths. But it was not only the battered health systems which boosted the spread of the virus, international response to the outbreak also exacerbated the infections and fatalities. The Guardian Newspaper reports[1] that:
Chaotic meetings with local ministers and health officials coupled with a dysfunctional local government and complacency in the west engendered a hellish downward spiral.
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The sharpest criticism is levelled at the WHO, which was slow to declare the Ebola outbreak an international emergency, but also failed to heed early alarm calls made by medics who were working in horrific conditions in the Kenema hospital.
The tardy response to the outbreak in Sierra Leone was engendered by the lack of resources, human and artificial, to combat the virus. In 2014, Sierra Leone had fewer than 500 trained medical doctors servicing a population of more than seven million. Its hospitals and clinics were as few and far between as they were grossly under-equipped to respond to any kind of disease outbreak. But in addition to the dearth in its healthcare delivery, donations and aid funds which were pumped in millions of US Dollars were siphoned off by local leadership. The government audit unit uncovered about USD14M which were funds which could not be accounted for during the efforts to beat the virus. Despite the damning audit evidence of suspected misappropriation of direly needed funds, no public official has been prosecuted for the missing Ebola funds to date. Although there are ongoing commission of inquiry processes which seek to probe into the missing Ebola funds, there is yet to be any findings or recommendations for prosecutions or restitution.
The emergency measures introduced by the government of Sierra Leone in consultation with international agencies and partners, though unpunctual, substantially helped to stem the rapid spread of the virus. On 7 November 2015, Sierra Leone declared its territory free from the Ebola virus after 42 days of continuous zero infection. The human and social cost of the havoc wreaked on the nation of Sierra Leone might never be quantified as would the unaccounted funds be irrecoverable. By the beat out of the virus, Sierra Leone’s medical personnel which was already in short supply was decimated. A dozen medical doctors, amongst them being, unarguably one of Sierra Leone’s leading medical doctors, Dr. Victor Willoughby lost their saves in a bid to defending their nation attacked by a deadly virus. While there was a cessation of the spread of infection, it was just the beginning of another episode of ordeal for the more than four thousand Sierra Leonean Ebola survivors. The government of Sierra Leone, as usual, pledged nothing shy of adequate facilities and allocation of state resources to Ebola survivors. The pitch of its promise was good, but as the years wore on, survivors’ anticipation of sufficient resources to attend to their post-Ebola health and other social challenges dwindle.
In January 2018, two unnamed Ebola survivors together with the Centre for Accountability and Rule of Law (CARL), brought an action against the Government of Sierra Leone in the ECOWAS Community Court of Justice. Sierra Leone is a signatory to the Treaty establishing the Economic Community of West African States and its protocol on the establishment of an ECOWAS Community Court of Justice. Amongst the mandate of the court is to hear and determine cases of human right violations by individuals of state parties. The suit prays for a declaration that poor structures within the healthcare sector, delayed response on the part of the government of Sierra Leone to the Ebola outbreak and massive misappropriation of funds/donations by local politicians accounted for the massive infections and deaths. The Plaintiffs, therefore have urged the ECOWAS court to hold that the right to life and health of not only the two Plaintiffs but also of all those survivors who were in similar situations were violated by the Government of Sierra Leone. There are no socio-economic rights guaranteed in the Constitution of Sierra Leone but the state of Sierra Leone is a signatory to a number of leading international human rights instruments which provide and guarantee the right to life, health and wellbeing of the peoples of state parties. Therefore, since a declaration of violation of fundamental social rights might be an uphill task in the municipal courts of Sierra Leone if not impossible to obtain, recourse had to be had to an international court which the state has signed up to, in this case the ECOWAS Community Court.
The state of Sierra Leone promised its more than 4,000 survivors pyscho-social support and an amelioration of the health systems in Sierra Leone to combat any future outbreak of the Ebola virus or any similar virus. Sadly, more than three years now, the healthcare system is as unprepared as it was, to deal with any medical and humanitarian crisis such as the one ushered in by the Ebola Virus Disease. The health complications of survivors subsist and their hopes based on the commitment of the government of Sierra Leone linger though worn out. It’s been four years since the end of the Ebola Virus in Sierra Leone, but there is no specialized unit for Ebola survivors yet. They continue to battle with and endure myriad health complications and nothing more than the free medical services which previously were only provided to pregnant women, lactating mothers and infants have been extended to Ebola survivors. Survivors’ complaints of sudden loss of vision, infertility, erectile dysfunction, prolonged fatigue, mental issues and undiminished social exclusion and stigmatization continue to rest on deaf ears. With these lingering issues come huge social cost on survivors’ livelihood. Such costs unbearable by their economic distress.
Sierra Leone has scooped the victory in the battle against the scourge of Ebola brought on her people but is losing the war on its survivors. The enduring agony of survivors remain a constant reminder of the defects in the health care system of Sierra Leone, which have all suddenly re-emerged. The signs of a likely national catastrophe in a magnitude similar or greater than the consequences of the Ebola virus are all too numerous. Unfortunately, the very indifference to the signs, which stoked the spread of the Ebola virus, have returned, like it only took a snappy break. The Ebola outbreak exposed the failings in the health sector of Sierra Leone but may have failed to prick the conscience of the nation to address the systemic failures and transform health institutions in order to combat such outbreaks. Sadly, the status quo ante Ebola has re-emerged and oblivion of the huge social and human costs has set in so suddenly. For survivors, they are left with diminished hopes and heightened health complications. The nation may not be recording any more infections for over three years now, but it’s recording huge failures in responding to the plight of Ebola survivors.
By: Augustine Sorie-Sengbe Marrah (24/02/2019)
[1] The Guardian “Book lifts lid on litany of mistakes in Ebola outbreak that killed 11,300 people” https://www.theguardian.com/global-development/2018/jul/30/getting-to-zero-book-mistakes-ebola-outbreak-oliver-johnson-sinead-walsh