The tragicomedy of the Ebola outbreak

Dr. Sama Banya (Puawui)

The Sierra Leone Telegraph: 30 May 2014

EBOLA-BILLBOARD-600-x-450It was a long time ago while I was still at Medical School. We were having a medical tutorial on Sexually Transmitted Diseases or STD as they are commonly referred to in medical circles.

I expressed my concern at one of the very serious tragic situations that I said I would have to deal with back home.

I then briefly informed both my tutor and my colleagues, of our system of polygamous marriage, particularly in the rural settings where a man marries several wives – and I outlined some of the implications.

I described two scenarios; the first was of one or other of the wives of the marriage, who would commit adultery, perhaps because of neglect by her husband.

If there were ten or more of them, it was often not be practicable that an elderly wife or even a younger one would share her husband’s bed earlier than two weeks or sometimes longer.

During that interval she might be tempted to fulfil her desire with a lover; it was also not uncommon that even with his ten or more wives, for a man to still be attracted to another woman who may herself be already in a marital home.

Whatever the situation may be, the man or woman may in their adventure contact a sexually transmitted disease, which in those days was more often gonorrhoea, the symptoms of which are not usually apparent for at least three days.

In the interval, the man may have had intercourse with one or more of his other wives.

In the case of a woman, the symptoms take longer to manifest themselves, and she may infect an innocent husband as well. Thus from that one act of indiscretion, the infection spreads quickly by geometric progression of 2, 4, 8, etc. etc.

The man gets treated in hospital with antibiotics and then innocently goes to bed with one or other of his wives, who may already be infected and so the cycle repeats itself, often spreading even wider.

Mercifully, in those days, gonorrhoea and sometimes syphilis were the main offenders, HIV/AIDS appearing on the scene only recently – thank God for that.

poor weather3And now, after much precautionary preparations, including arousing public awareness and exhortations, the dreaded killer – EBOLA virus, has entered Sierra Leone, not surprisingly along our Kailahun district’s porous border with Guinea, where cross border traffic is heavy and often undetected.

The initial source of infection was a woman now dead.

In spite of the numerous warnings (but did the message get to her village at all?), other family members were involved in the burial proceedings, and now we have confirmed cases of a modest spread so far.

I am not sure of the distance of the affected village – Sokoma from Koindu, but the latter town which is the Task Force centre is some 100 miles to Kenema, where the confirmed and suspected cases are or were to be transferred.

Were the patients to go along with some family members, and if so, who would look after them during their stay or provide their fares home – whether or not their patient recovered?

Yes, this is a very serious but realistic medico-social problem, what may be termed the “HOLISTIC “treatment of the patient.

By that is meant not just the disease, but the social and environmental background of the patient.

If no thought had been given to that aspect of the patient’s treatment, little wonder then that family members have reportedly refused to let their patients travel to Kenema.

Needless to emphasize the very serious situation that may result from that action; chief of which is the likelihood of more cases of infection – firstly, in the affected village of Sokoma, and later in the rest of Kissi Teng chiefdom and beyond.

Miatta Kargbo - health minnsterI do not envy the minister of health and sanitation, nor Brima Kargbo the chief Medical Officer, or the man directly responsible for Infectious Disease Control – Amara Jambai.

Perhaps this type of scenario is taught in Medical School today. But I doubt it.

It is therefore reassuring that an international expert team is arriving. I hope the first thing they do is to establish a field hospital in koindu, so as to make things simple and attractive to the community, as well as allay their fears of a long journey to Kenema.

Yes Ebola is for real; ‘nar true, nar killer infection.

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