Sandra Lako: The impact of Ebola in Sierra Leone

sandra_lakoToday is the 228th day of the Ebola outbreak in Sierra Leone. A year ago I would not have believed anyone who told me that I would be in the middle of an Ebola outbreak in January 2015. A confirmed Ebola case in West Africa never crossed my mind. Even in May of last year, when the first positive case in Sierra Leone was announced, I could not imagine the extent to which this virus would spread throughout Sierra Leone. No one was ready for the battle we are up against.

To date there have been 7696 confirmed cases in the country, affecting people in every district. Still the virus is looming. It has been an incredibly challenging time for Sierra Leone. Life and work for many people has been consumed by this outbreak and sometimes it is hard to remember a time without Ebola.

Ebola is a terrible disease, causing suffering and death, but its effects go far beyond the illness alone.

Ebola has caused an already fragile healthcare system to collapse, with people afraid to access clinics and hospitals for fear of contracting the virus and healthcare workers anxious to provide care for similar reasons. Some health facilities are closed and others only provide outpatient services. This has led to an increase in morbidity and mortality from more common illnesses and gaps in essential health services. Fortunately people’s confidence in the healthcare system is slowly being restored and at the Ola During Children’s Hospital we are experiencing an increase in the number of non-Ebola cases being admitted to the regular wards. Healthcare workers are starting to feel more protected owing to increased access to personal protective equipment and additional training, however, the loss of over 300 healthcare workers in Sierra Leone due to Ebola still weighs heavily on health professionals with many of them often wondering “Who will be next?” In a country with long standing shortages of healthcare professionals these losses will be felt for years to come.

The impact of this outbreak extends much further than the healthcare sector alone. Many children have been orphaned due to this disease. Families have been wiped away. Some survivors are stigmatized and shunned by their communities. Businesses have closed and trade is limited. Primary and secondary schools have been shut for months with children accessing what little education they can by radio or personal tutors at home. It is unlikely that the College of Medicine and Allied Health Sciences will produce any graduates this year. Farming has come to a halt, leading to food shortages across the country. Every sector and every person is affected by this outbreak.

Thankfully in some parts of the country, the number of cases has significantly reduced. In Freetown, (Western Area) the numbers seem to be stabilizing, but it may still be too soon to tell. There are fewer patients in our holding unit, but that is likely due to the fact that patients are now spread out across more facilities. Even if the number of cases has not dropped, I do know that the number of holding beds for isolation and testing, and treatment beds for confirmed cases have increased considerably over the past few weeks, which is essential for the containment of this virus and breaking the chain of transmission. This gives me hope.

We are all working hard to make sure that this outbreak ends and despite the difficulties, it has been amazing to see the resilience of my Sierra Leonean and international colleagues and the sacrifices that everyone is willing to make in order to achieve a common goal: an Ebola free Sierra Leone.

Read more about Welbodi Partnership’s response to the Ebola outbreak.

Read more about the impact of Ebola on child health.

Competing interests: None.

Sandra Lako is a doctor from the Netherlands who has worked in Sierra Leone for the past nine years. She spent the first half of her time setting up and managing a paediatric outpatient clinic with an organisation called Mercy Ships. She then joined Welbodi Partnership, a UK based charity supporting the only government run children’s hospital in the country. As country director, Sandra is leading the team to expand their work to the maternity hospital and a community hospital with the aim of improving the accessibility and quality of healthcare for women and children in Sierra Leone.