Nearly three years after Ebola was kicked out of Liberia, series of training and awareness messages have been carried out. Health Care Workers (HCWs) were trained in Safe and Quality health Services (SQS) specifics to infectious diseases.
But with the recent outbreak in Sinoe County, it can be highly deduced that the Health sector is still swimming in the pre-Ebola status after millions of dollars have been pumped into it for surveillance, health strengthening, recovery and preventative public health activities. Especially, Infection Prevention and Control (IPC) and timely dissemination of public health messages/results.
Since the deadly Ebola Virus Outbreak devastated the country, Liberia has never been tested with similar disease or different type. Even the Ebola Preparedness and Response (EPR) training that was conducted in various counties is yet to be evaluated with self-created/stimulation exercise that will test the response level from health care workers in some county.
The “strange killer disease” that till date had killed 12 people in different locations (Sinoe 10 and Monsterrado 2) is yet to be named after 9 days. This disease was traced to a burial ceremony of a “religious leader” who died due to “high blood pressure” (FrontPage Africa).
On the part of the county authority, they must be relatively applauded for the level of response at their level. But nationally, a more robust outbreak response plan and execution was needed in terms of social mobilization, surveillance activities (contact tracing) etc.
Consequently, delay in disseminating information surrounding the unknown killer, made citizens to panic because of their experiences and perceptions about EVD. As the result, other migrated to the capital city and other parts of the country unnoticed or undetected leading to some deaths and contacts reported in the capital-similar to the spread of the Ebola Virus.
Holistically, the Sinoe outbreak questioned the country’s preparedness level in case of any outbreak insinuated by stakeholders and some authorities. Level of preparedness as they perceived is highly based on past experiences, lesson learned from previous outbreak- perceived preparedness is more likely abstract.
But in actuality, many NGOs and local NGOs who were involved with the surveillance activities have withdrew while some have slower their supports. As such, most intra Ebola outbreak precautionary measures (hand washing stations, avoiding crowded areas, burial practices etc.) that relatively helped contained the outbreak had resumed.
Concerns are raised over sending the specimen abroad for testing as stated by the Chief Medical Officer of the Republic. This gap of not testing the specimen collected from the victims has the greatest disadvantage of rapidly spreading outbreak.
This is because when public become doubtful of the actual cause(s) of an outbreak or other diseases, they migrate in search of refuge, rumours term to escalate exponentially causing further harms-disease will spread rapidly and because of fear, other contrary healthy measures will be taken.
Why was the specimen not tested in country?
What happened to the reference Lab and the regional laboratory with regards to testing of said specimen? Flying the specimen abroad showed that many post Ebola recovery programs especially the laboratories are Ebola specific instead of being able to test other outbreaks or diseases that maybe contagious (spread from one person to another).
Worth noting, specimen collected from cluster of unknown death which is part of the priority diseases of the nation being transported by Riders for health on motorbike instead of using an aircraft deepened preparedness concerns.
No Health Care Worker (HCWs) has been infected so far.
The good thing this time around for the health care workforce is that no one has so far been affected. For this part, can we analyse that the health work force is more prepared than the populace? If so, preparedness in this context is questionable. This is because the population is the employer of every HCW and the entire health care sector is patient centered.
As I close, I will like to boldly say that this outbreak served as a little test for the health sector that must be taken seriously or else, evaluation of recovery and health strengthening programs will be disproportional to resources allocated.
Again, the health authorities and major stakeholders need to evaluate major public health projects, conduct regular or refresher trainings, and put people in positions for which they are schooled. Quality Assurance must be conducted or instituted for projects or trainings that are meant to build broken public trust due to mistrust while keeping the surveillance system as routine regardless of zero case.
In a nutshell, until the health sector and authority involved attach more public health benefit or impact to timely dissimilation of health related events or outcome to people in most need, level of preparedness in term of future outbreaks and public health threats still remain a greatest public health concern.
Eddie Miaway Farngalo is the Head of the Research Department at the Center for Liberia’s Future which is currently conducting a national study on community perceptions about Ebola and the reintegration of Ebola survivors, orphans and caregivers. Contacts: +231886484351/+231777590035: Email: [email protected]