Ebola Resurgence: ABC Secretariat stems the tide

The Attitudinal and Behavioural Change (ABC) Secretariat has passionately contributed in stemming the tide of the re-emergence of Ebola in Sierra Leone by working closely with stakeholders in the Ebola response process on Community Ownership, Management and Monitoring of Ebola Operations between 12th and 19th September, 2015 in Kambia and Bombali districts.   (Photo: Dr. Ivan Ajibola Thomas, ABC’s Executive Director)

It was reported that a new EVD positive swab was tested in Kambia on 29th August and another in Bombali on 13th September, 2015.

During the engagement, the Executive Director of the ABC Secretariat, Dr. Ivan Ajibola Thomas expressed dismay over the resurgence of Ebola in Kambia owing to the fact that Kambia was doing extremely well in the initial stage of the fight against the disease.

Dr. Thomas disclosed that the aim of the Secretariat’s visit to Kambia and Bombali districts was to investigate the reason (s) for the reemergence of Ebola, and also to stir up the various response teams  particularly the paramount chiefs to take ownership of the fight as custodians of their chiefdoms.

He pointed out that community ownership is key in fighting against Ebola and local authorities should take ownership of the fight by ensuring that their people keep to the rules and adhere to the bye-laws. Dr. Thomas stated that the paramount chiefs have authority over their people and the District Ebola Response Centres should continue to work tenaciously with the paramount chiefs and other authorities to enforce and reinforce the Ebola preventive messages through persuasive education and communication. “We  have to emphasize and reemphasize these issues until people internalize them and abide to these messages. If we do that then we are sure we will be able to kick Ebola out of the Sierra Leone,”

He warned that lapses in the community ownership strategy will continue to hamper Sierra Leone’s success against Ebola if not addressed urgently. He called for proper collaboration between the paramount chiefs and DERC, and other partners in the response process.

He went further to state that upon preliminary investigation it is evident that  “exhibition of negative attitude and behaviour is again responsible for the resurfacing of Ebola in the country.” People are still reluctant to adhere to the community bye-laws, medical advices and restrictions as they continue to wash the dead, and treat the sick at home, and refuse to observe the infection prevention control measures as instituted.

He averred that the ABC Secretariat will continue to work hard with partners in the Ebola and post-Ebola strategies to once and for all make Ebola a thing of the past and also to revitalize our national development gains.

The Minister of Agriculture, Forestry, and Food Security, Dr. Sam Sesay told the ABC Secretariat that he has been providing support to his people in Tonko Limba chiefdom as a descendant of Sella Kafta village. He pointed out that before Ebola struck he provided bags of rice, beans, cooking oil, and other food and non-food items for his people and those items were used at the initial stage of the fight against Ebola together with other prominent descendants of Tonko Limba chiefdom.

As recently as September 2015, Dr. Sam Sesay disclosed that he has provided medical items for all seven (7) chiefdoms in Kambia as a way to improve health care service delivery in the district.

He described the recent outbreak in Sella Kafta as a success because of less causality out of the 49 high risk contacts adding that the inoculation of the vaccine helped greatly. He continued that his personal engagement with his people has positively influenced the fight in Kambia district by getting his people in Tonko Limba to adhere to the Ebola protocols. However, “we must maintain vigilance because Ebola is not yet over and it has affected our socio-economic development progress,” he cautioned.

Kambia District Ebola Response Coordinator, Dr. Alfred Kamara averred that prior to the re-emergence of Ebola, Kambia had gone over 50 days without recording a new case adding that the new EVD positive swab was a woman approximately at age 67 who had been secretly treated in her house before her death and they later called 117.  Dr. Kamara stated that although DERC has released about 98% of people from quarantined homes in the Sella Kafta village, yet a missing high risk link by the name of Kadiatu Kamara is still pulling the ground from under Kambia’s feet to Ebola success.

He pointed out that lack of indigenes participation in addressing the resurgence was a major challenge adding that physical presence of the descendants from every district is a primacy and that would have aided them to address the situation swiftly because they understand their people better and they can discuss on interpersonal terms. He continued that at the initial stage fight, they instituted the Kambia Community Action Plan (K-CAP) that was successful largely due to the intervention of the descendants in their respective chiefdoms as they stayed with their people for 21 days and that

was the breakthrough for them; “I believe that anytime we have a case the same team should come back and if they keep coming it is very case for us to end and win the fight,” he advised.

Dr. Kamara said the presence of the indigenes cannot just be felt in Freetown, adding that it’s all about attitude and behaviour change.  “These are the ones who are suppose to set the example by coming down to the ground because they are the opinion leaders,” he added.

He said incentives should be taken off the response process because that too is causing unnecessary blame game and also affecting the fight; “if we cannot save the snake in our compound who do we call to kill it, it is our responsibility to kill the snake. If we need more we will go into the fight in 5 years from now because we will focus on our personal benefits; this is our fight and until we all come onboard it is going to be tough,” he said.

Paramount Chief  Bai Farma Tass Bubu N’gabak informed the ABC that there are lapses in the implementation of the community ownership strategy dubbed “Operation Enduring Zero”

because they were excluded from the entire operation. He added that this situation among others causing the people to report more death alerts than live alerts. He said people are reporting less sick cases but more death cases because they do not trust the aliens who come to engage them, rather than their paramount chiefs.

He appreciated the stance of the government for not lifting restriction on secret society activities as that would have compounded their problems in getting their people to comply with the bye-laws, medical advices, and the state of public health emergency. He assured that they will continue to implement and enforce the community bye-laws throughout Kambia district especially on secret society activities.

He ended by encouraging the people of Kambia to take the trial vaccination which will start in October with a sample population of forty (40) people…

The District Ebola Response Coordinator in the Bombali district said that the new infection in their district has nothing to do with a survivor because the last Ebola survivor from Robuya village was on 29th November, 2014. ” Let us don’t stigmatise survivors, they have no link to this.”

We have put mechanism in place that as a district all alerts meeting case definitions should be validated, hence forth. I have told the surveillance team not to convey any alert meeting case definition without consulting the District Medical Officer (DMO). We have no doubt in the IMC but for quality assurance we need to validate; our people are tired. He craved the indulgence of the people to step up their effort in the fight against the outbreak in the district by maintaining vigilance and the status quoi.

ABC’s National Coordinator and Second-in-Command, Madam Nanette Thomas appreciated the robust support and corporation of domestic and international organisations such as PLAN Sierra Leone, World Food Program, World Health Organization, KADDRO, and others. She however cautioned that the war against Ebola is not yet won and people should continue to observe the Infection Prevention and Control measures, medical advices, and bye-laws.

Madam Thomas opined that the ABC Secretariat as a good governance institution will continue to work with other institutions and partners to reflect the government’s agenda and goal for sustainable socio-economic development. She added that the fight against Ebola is not yet over and emphasized the need for proactive community ownership for proper coordination of activities even after Ebola.

For all of the given time interval, the ABC Secretariat found out that there were lapses in community ownership, minimal descendants intervention, prevalence of negative attitude and behaviour, no clear establishment of epi link, complacency in the use of the IPC measures, among others.

The Secretariat also distributed boxes of condoms to the appropriate authorities in Kambia and Bombali districts to be distributed among Ebola survivors.

ABC Secretariat

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