President Ernest Bai Koroma addresses Sierra Leone’s Ebola problem at World Bank Round table

HE Koroma

By Dr Ernest Bai Koroma

Since the first cases of the disease in Sierra Leone in May, over 2500 of our people have been infected, of which there are a little over 530 survivors. Our people are dying, children are being orphaned, most of the dead are women and over two-thirds of those infected belong to the most economically active age category of 15 to 50. Children are not going to school; doctors and nurses are dying, and non-Ebola illnesses are adding to the toll of death and suffering due to further weakening of the healthcare system in the country.

This Round Table is very important for us, the fight on the ground in Sierra Leone urgently needs the support of people gathered here today to combat this virus; without you we cannot succeed, without your quick response, a tragedy unforeseen in modern times would threaten the wellbeing and compromise the security of people everywhere.

This is not a disease we brought upon ourselves. In Sierra Leone we were implementing policies that were making our country one of the fastest growing economies in the world when Ebola struck. Ebola is now causing great disruptions to agricultural, mining, manufacturing, construction, tourism and transportation; and posing a significant threat to human development, state security, and poverty reduction. Government revenues are drying up; the livelihood of our people compromised.

Most of the resources expended so far in this fight have been our own resources. This is changing, and we laud the World Bank for hosting this Round Table, for increasing its allocation to our countries, and for speeding up its approval processes to get resources to the ground. We laud our other partners for infusing more urgency into their Ebola response.

The last few weeks have indeed been weeks of massive concerns and commitments to fight the outbreak. However, the general international response has up to this moment been slower than the rate of transmission of the disease. This slower-than-the-virus response needs to change. I am here to seek acceleration of the translation of commitments to physical facts on the ground. That is what is urgently needed now: commitments on paper and commitments during meetings are good; but commitments as physical facts on the ground are best.

These are the physical facts on the ground that must be urgently deployed in our race against the virus:
1. A Community Ebola Care and Holding Centre comprising 20 beds in each of our 149 chiefdoms and 20 centres in the Western Area, giving a total of 169 Community Ebola Care/Holding Centers.

2. Treatment Centers: the country requires, strategically placed treatment centers holding a total of 1500 more beds.

3. Personnel: The 1500 additional treatment center beds would require a recommended number of 5250 health personnel including 750 doctors, 3000 nurses and 1500 other support staff of hygienists, counselors, and nutritionists. The Community Care Ebola Centres also need trained health workers with medical doctors supervising a cluster of them.

3. Equipment and Logistics: These include PPEs, IV fluids, anti-bodies for super imposed infections, food supplies, 200 ambulances to service the nation wide network of treatment centres, and community Ebola care units, 1000 motor bikes for contact tracers and 200 4WD utility vehicles for supervisors, surveillance officers, and burial teams

4. Laboratories: There are currently four customized Ebola labs in the country able to do less than 150 samples per day. We need five more labs strategically located in the country to enhance quick turn around from the taking of samples to the presentation of results. Importantly also, support is required to ensure lab safety for health workers and prevent samples from falling into wrong hands in this age of terrorists who may seek to spread mayhem with the Ebola virus through bio-terrorism.

5. Funds for Incentives and other Expenses: Millions of dollars are also required to pay the thousands of health workers that would be deployed; millions of dollars are needed to shore up drug, food and other basic supplies and logistics.

6. Psychosocial Support: The Ebola outbreak is devastating for children and women and communities and these would need psychosocial support; orphans would need care, widows require support, and survivors help with meeting the challenges of stigmatization.

7. Other Support Services: The fight requires communication support to facilitate contact tracing, transmission of lab results, and general logistics chain management.

8. Sustainability: We know that the present Ebola Response is an emergency response but sustainability must be integrated into it in order to enable us to respond more quickly to a recurrence of the Ebola after this current one. The literature tells us that Ebola outbreak often recurs in all the countries that it had manifested itself. This would require the medium term transformation of makeshift centres into permanent ones; ongoing training of health personnel in the country; and establishment of a National Public Health Institute with surge capacities

9. Kick Starting the Economy: the disruptions to economic activities pose a major challenge in domestic revenue mobilization, investments, external trade and livelihoods. Therefore, the support of multilateral financial institutions is critical in addressing the emerging financing gaps in the fiscal and external sector accounts of affected countries. Support is needed to enhance post Ebola investments, restore livelihoods, prevent more suffering; and strengthen our capacity for partnerships in peace-building, for good governance, and socio-economic development.

We very much welcome the establishment of UNMEER, and we salute the commitment to support the fight with holistic sub-regional emphases. In furtherance of this, we are proposing a sub regional Mano River Summit with UNMEER to tighten our plans, bridge gaps and move forward. Ebola out of any of our countries is not really a success until we get Ebola out of all our countries.

Distinguished ladies and gentlemen, the situation is new, complex and evolving; current deployments are not enough if we are to get ahead of the virus and stop it. Now is the time for action in logistics, now is the time for action in establishing and staffing additional treatment centers; now is the time for getting clinicians, nurses, lab technicians and others on the ground; now is the time for fast tracking the translation of commitments to positive facts of response on the ground. This is a race to get ahead of this evil virus; this is a race for all of us. I am hopeful; we shall win this fight; we shall prevail; we have already ensured hundreds of survivors, we have to ensure the survival of tens of thousands more; we will kick Ebola out of our countries.

I thank you for your attention.

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