Sierra Leone on edge over prospect of cholera outbreak

A panoramic view of Mabella, one of tens of slums surrounding Freetown. Life here is pathetic to say the least

By this time last year, Sierra Leone was in the middle of its devastating cholera crisis.

With 299 deaths and over 23, 000 infections, it was described as the country`s worst in 15 years.

This time though the government seems determined to prevent, or at least mitigate, the effect of what is increasingly becoming inevitable.

As of last Monday 193 suspected cases had been reported and at least four deaths out of six confirmed cases, according to media reports.

The Ministry of Health and Sanitation (MoHS) insists it is only two deaths and that the situation is not yet an outbreak.

In a press briefing last week, officials of MoHS acknowledged

reported rise in cases of diarrhea and vomiting - over 13, 000 as at August 17 - symptoms of cholera.

However, warned Dr Joseph Kandeh, District Medical Officer Western Area, this must not be mistaken for cholera.

Squalid living conditions across the country have always been blamed for the persistence of the epidemic, as well as lack of awareness and proper medical facilities.

The situation is hardly different this year, but the government is hopeful that new measures in place already will help prevent a repeat of the 2012 experience.

The newly established Central Public Health Reference Laboratory (CPHRL) in the west of Freetown, the capital of Sierra Leone, means that specimens of suspected cases no longer have to be flown out to Dakar or Abidjan for testing. That was a major cause of delays and worsening of last year`s situation.

The Health Ministry is also relying on the recently commissioned mobile technology used to advice the public and enable them request emergency response.

By mid August last year, over 100 deaths had been recorded. That contrast sharply with this year`s less than five deaths.

Dr Foday Daffe, Manager of the National Disease Surveillance, attributed the current low infection rates to rise in awareness levels.

However, it`s obvious that there is no room for complacence, and the Health ministry is in no illusion about this as some officials have admitted that complete eradication may not be possible thanks to overcrowding in cities and towns.

The ministry has set up cholera centers in case of an eventual outbreak.

Difficulty in accessing safe drinking water particularly in Freetown`s swelling slums leaves inhabitants extremely vulnerable.

In spite of the air of optimism, realities in slum settlements like Mabella, where last year`s outbreak first emerged, show that it`s just a matter of time before the inevitable occurs.

Surrounded by her family and neighbors, Zainab Kamara explained the difficulties they go through in the community.

The only one makeshift toilet that provides some semblance of privacy costs a fraction of a dollar to utilize. Added to the payment burden you will have to summon more than enough courage to venture into it, given its grubby nature.

You also have to queue, which means you are doomed if you contract dysentery, noted a young slum dweller.

The same waterside into which the content of this toilet empties serves for bathing and other domestic purposes.

“They (government) only left with us dogs,” chides elderly Mrs Kamara.

“We have no toilets here. When we want to ease ourselves we have to go to the sea,” she added.

She said their children are constantly diagnosed for all sorts of diseases - chicken pox, malaria and measles.

Community nurse Mariatu Kamara, concurred, adding pneumonia, diarrhea and cholera to list.

“Communities like this needs critical attention,” she said.

Another dilemma is the filthy nature of hospitals and health facilities across the country.

President Ernest Bai Koroma was “shocked” by a recent report on the country`s main hospital in Freetown - Connaught.

Out of seven areas identified by a ministerial Task Force that had been set up to investigate the deteriorating situation of the hospital were unsafe, insecure and worn-out facilities.

As a short term measure, the government has declared this Saturday, with the likelihood of extension to Sunday, a general cleaning exercise for the whole of Freetown.

There is also a newly commissioned job creation scheme which pays youth in slums to clean their surroundings.

Corporate bodies like banking giant, Standard Chartered, have since begun their sensitization program alongside distribution of Oral Rehydration Solution (ORS) to inhabitants of slum dwellings.