How to eradicate Ebola using a reward system

By: Brima Michael Turay – PRO MEST

The Ebola Virus Disease (EVD) was first detected in Sierra Leone in the month of May 2014 in the eastern district of Kailahun, close to the border with the State of Guinea. The disease has now spread to all parts of the country. This is posing serious problems for the government in terms of its capacity to harness its limited resources to fight such a strange disease in this land.

The government, in its effort to provide structure around the fight against the disease, established the Presidential Taskforce on Ebola and the Emergency Operation Center (EOC), now named National Ebola Response Centre (NERC). The President also proclaimed a state of Public Emergency as a way of strengthening the structures that are working very hard to contain the disease. This state of Public Emergency created some limitation to the functioning of certain government entities and the movement of individuals from one place to the other. Nevertheless, people still sneak through porous checkpoints or use backyard bush paths; rivers and streams by boat, to get to the city of Freetown, especially from Port Loko District which has now become one of the highly infested places in the country. This is the result of an attitude problem and a problem of lawlessness by certain Sierra Leoneans.

I am therefore suggesting an idea that may seem very unconventional; or perhaps even unrealistic; but given the attitude of the Sierra Leonean toward money making and finding the daily bread, I strongly believe that this idea will work. This idea is no other but a reward system to fight against Ebola after every other idea that we have applied as a nation in this fight. This may sound farfetched because it sounds too simple of a method and not too many people are thinking along those lines but I will endeavour to explain this idea and processes in the justification part of this concept paper.

Justification:

Apart from government spending, which has amounted to Billions of Leones and Millions of Dollars, government has also attracted a lot of support from the international community, especially China, Britain, Cuba, the USA; and other entities like the World Bank; ADB; EU and several other institutions to help in the fight against this dreadful disease. The nation’s economy has been badly bruised and our desire to become the fastest growing economy has been halted by the appearance of this strange disease in our land. From the President to the NERC officials to the Doctors, Nurses and Healthcare workers; to citizens of this nation; every sector is spending sleepless nights to find a way of curbing and eradicating this disease which has become an economic predator in this land. Even with all of the above efforts, our numbers are still alarming. As at 11/22/2014, the total number of cases that have tested positive since the month of May 2014 stands at 5,355; with 1,303 deaths and the fear of that number even rising on a daily basis still looms over our heads. Western Area Urban alone stands at 1,056 while Western Rural is trailing at 751 confirmed positive cases. We have increased the number of our Contact Tracers and Surveillance Officers; and we have also decentralized the EOC, now NERC to district levels, which is an earlier suggestion that I made in the first document that I put together in which I suggested this reward system. What now remains is to apply the Reward System. How does this work, one may ask?

Rationale

In every NERC office in every district, let us allocate Le500, 000,000 (Five hundred Million Leones; which is approximately $112,000). This will amount to Le7, 000,000,000 (Seven Billion Leones; which is $1,555,555) for the 14 districts in the country. Arrange with the main Banks in the district to lodge this money into a special account. Sensitize the nation through the telecommunication companies and the political representatives to draw the attention of the constituents to an Ebola Reward System. We can say that if you suspect a sick person with symptoms of Ebola in your household or community within your district, you can safely report either directly or anonymously to the NERC officers in your district. The name and phone number of the reporter is taken down and he or she is given a specific code that is tied to the account in the bank in the district where the money has been lodged. The Medical Teams will then pick up this reported case and obtain samples. If the reported case tests positive for Ebola, we will give the reporter a reward of Le500, 000 or Le1, 000,000 as the case may be. If someone comes forward voluntarily and reports and he or she tests positive for Ebola, we give him or her a reward of Le1, 000,000 or Le2, 000,000 as may be agreed. The bank will only pay out to the reporter after submitting the code number from the NERC office bearing the name of the case that has tested positive. If the reward is Le500,000 per positive case; for every 100 positive cases in any district, government is only going to spend Le50,000,000 (fifty Million Leones) to bring those cases out and put them in a holding center or treatment center as the case may be. Therefore, a district would have to have 1,000 cases in order to exhaust the Le500, 000,000 that is allocated to that district. I don’t think we have 1,000 positive cases in each district. Sierra Leoneans always like to make money in anything they do. If this idea is tested, you will come to realize that even those hidden Ebola suspected cases will be brought out immediately the reward system is announced. One of the reasons why some people find it difficult to report to the nearest hospital when they feel the symptoms of Ebola is the fear of being put in a hospital while the family is at home languishing. If people who are experiencing symptoms of Ebola know that by reporting to the NERC office and after being tested positive they will have money to leave with the family at home, they will come forward. This will help to identify the positive cases across the country and consequently help to contain those cases. It will curtail the spread of the virus; and eradicate the disease sporadically within a very short period of time.

Skepticisms:

There are those who would be very skeptical and say this will bring chaos. Some would say people will report cases randomly in order to make money. I understand the reasons for their skepticism; but how much chaos have we not had already since this disease appeared in our country in the month of May this year? We have seen people throwing corpses on the streets of Freetown, to be specific; and suspected cases running away to avoid being isolated in a hospital or holding center. We have seen attempts by others to misappropriate Ebola resources by stealing fuel and other Ebola-related materials. A lot of money has been spent on sensitization and only God knows how many people actually did a thorough sensitization and spent the money for the intended purpose. Since we don’t know, we can only try to minimize wasteful spending by using simple common sense methods around this fight.

Even if someone reports one million cases, that individual is not going to make money until and unless those cases test positive for Ebola. It is plain and simple. Now that we have stabilized our burial teams and have put in place a mechanism to pay our health workers on time, we need to consolidate those gains by making sure that we apply common sense methodologies such as the reward system to finally eradicate this virus from our land.  By even applying this reward system, we, as a nation, would be able to identify other diseases that are present in our land by district and by region; and that alone will inform the manner in which we transform our health sector to cater for the vast majority of sick people around the country. We can try this method using just one district as a test case and see how it works. Once we succeed in one district, we would then proceed to other districts. It does not hurt to try. Let this be one of the many other interventions that we have applied in the fight against this disease. I hope we eradicate this disease from our land by the end of December 2014 so that we can go back to normal business by the start of 2015.