Sierra Leone Telegraph: 4 November 2015
Senior officials from the Ministry of Health and Sanitation, officials from WHO, DFID and the Commonwealth this week conducted a four-day assessment tour of six of the districts in Sierra Leone worst affected by Ebola. (Photo: Health ministry officials).
As the people of Sierra Leone wait in anticipation of the WHO declaring the country Ebola free on the 8th of November, according to the ministry of health, the district visits were aimed at getting first-hand knowledge of the level of preparedness of the districts, ahead of the transfer of responsibility for monitoring and reporting from the National Ebola Response Centre (NERC), directly to local and District Health Management Teams (DHMT).
The six districts visited were Port Loko, Kambia, Bombali, Koinadugu, and Tonkolili – all in the north of Sierra Leone, and Kono in the east.
Addressing staff of the Koinadugu District Health Management Team, the Chief Medical Officer and Team Lead – Dr. Brima Kargbo, commended staff for the hard work in the fight to contain the Ebola virus disease in their district, observing that a lot has been achieved and encouraged them to do more. (Photo: Chief Medical Officer, Dr. Brima Kargbo).
The visit he said was aimed at reviewing district level preparedness for establishing and sustaining minimum standards in all health facilities across the country.
Dr. Kargbo spoke about the need to ensure that all mainstream health facilities are capable of effective surveillance, triage screening, infection prevention and control, case management of possible Ebola virus disease cases, and safe provision of optimal care for all patients.
November 8, 2015, Dr. Kargbo said is expected to be declared Ebola free in Sierra Leone, and on the 31st December, 2015, the National Ebola Response Centre will hand over responsibilities to the Ministry of Health and Sanitation.
He told officials that the ministry should be prepared to take full responsibility to improve health care delivery services in the country, so as to prevent and respond to any future outbreak.
The Chief Medical Officer stressed that the capability of the country in developing a resilient health care delivery system, lies in the hands of the Ministry of Health. He appealed for team work to move the health system forward, and called on the DHMTs to identify gaps, and submit budget proposal to the Ministry for support.
The WHO Clinical Lead – Tim Dempsey, described the transition as very important, noting that it could move the country’s health care delivery system forward for sustainable development. (Photo: WHO Clinical Lead, Tim Dempsey).
He informed health officials and stakeholders that four special infectious disease units would be established at the 34 Military Hospital in Freetown, Kenema, Makeni and one in either Bo or Kono, respectively.
He stressed the need for safe isolation centre in every facility, so as to ensure they can conduct case definition, patient referrals and Ebola testing.
Tim Dempsey said that the visits not only focus on getting Sierra Leone to zero Ebola declaration, but to prepare the districts for future outbreak of any infectious disease. He urged districts to develop clinical guidance on diagnosis and management of Ebola virus disease, identify gaps in funding and submit budget proposals.
The District Medical Officer of Koinadugu, Dr. Francis Moses said that the last reported case in the district was on the 16th of April, 2015, over 194 days ago.
He said that the district has succeeded in putting in place; surveillance, laboratory facility, contact tracing, isolation, case management, social mobilization, community engagement and survivor care programmes.
In preparation for the transfer of responsibility from the NERC to the districts, Dr. Moses said they have established Public Health Emergency Management Committee, District Disaster Management Committee, District Emergency Operation Centre, and conducted staff training.
But the District Medical Officer said that more resources are needed, especially in terms of vehicles and ambulance, ambulance drivers, nurses and paramedics, isolation staff, screening and triaging, data management and vehicle maintenance.
Dr. James Akpablie who is a Health Systems Specialist from the Commonwealth, emphasized the need for continued surveillance, social mobilization and community engagement, whilst acknowledging the need for more resources.
Dr. Akpablie appealed for effective border screening between Sierra Leone and Guinea, as Guinea continues to struggle to control the virus.
In Kambia, the District Medical Officer – Dr. Foday Sesay said that there is a high risk of Ebola virus disease being imported across from Forecariah in Guinea,.
He said they are currently conducting intensive surveillance in all chiefdoms, with focus on border control using 12 integrated teams.
In the area of transition and recovery, Dr. Sesay said they are working towards a smooth transition from NERC to the DHMT, with effective district epidemic preparedness and response systems being put in place.
He added that there is need to strengthen the coordination of epidemic response, improve laboratory capacity for processing and testing of samples, effective management of suspected EVD cases and other epidemic prone diseases.
The Acting District Medical Officer of Koidu Government Hospital – Dr. Ronald Marsh spoke about the high level of preparedness in the district. He said that the government hospital has eight isolation beds, and the Condama Community Health Post and Kayima Community Health Centre have two isolation beds respectively.
He also said that they have developed transition activities, produced a district incident management organogram, identified District Emergency Operation Centre membership, and established clearly defined roles and responsibilities for the delivery of minimum standards in the district.