Ebola takes a new twist in Sierra Leone

Sierra Leone Telegraph: 5 April 2015

The hopes and dreams of the people and authorities of Kailahun district were dashed yesterday, after celebrating one hundred and eleven Ebola free days, when the government announced that a child has died in the district of the Ebola virus.

This news brought shock and confusion not only to the district, but across other regions, where Ebola has become entrenched, and people and health agencies have been studying the success of the south-eastern districts in keeping Ebola out.

When Ebola struck Sierra Leone in March last year, Kailahun became known as the epicentre of the virus.

But with the resolve and determination of the local communities and their local authorities, Kailahun not only became the second district in the country after Pujehun – another south-eastern district – to go without Ebola for 42 consecutive days, but had clocked an enviable one hundred and eleven Ebola free days.

Residents in the district who are now refusing to accept the result of the blood test carried out on the dead child, believe that they have worked very hard at maintaining a clean bill of health, until yesterday, when hopes of continuing to be regarded as pioneers were dashed by the government’s announcement.

A statement released by the office of the district chairman – Mr. Alex Bhonapha, says that, “Kailahun district council is contesting the new Ebola case reported for Kailahun by the Sierra Leone government today.”

The Chairman says that not only is he questioning the circumstances surrounding the case but, “strongly contesting the validity” and is asking the government of Sierra Leone to provide details of the case to the world community.

So what are the circumstances leading to this case? This is what the district council chairman says:

“We are strongly contesting the validity of the one case today in Kailahun. The world has not been given the true story.

“A young child of 9 months, fell ill and was hospitalized at the Nixon Memorial Hospital in Segbwema.

“They requested blood transfusion and a donor offered his blood.

“Eventually the child died and a swab was collected to verify the cause of death. It is this result that has created doubt in the whole system.

“My position on this matter is that for a person to be infected, he/she ought to have encountered one or combination of the following:

1. She/he has to come in contact with an already infected person.

2. She/he must have touched the vomit, urine, saliva, excreta or the sweat of an infected person.

3. In the case of an Ebola survivor, she/he can infect another person through breastfeeding or sexual intercourse.

4. Or in the case of a patient in need of blood, if the donor is an infectious person or a survivor within the grace period of abstinence (3-6 months ).

“This is my argument: If they claim that the swab result showed that the nine months old child died of Ebola, she/he must have got the virus from the immediate care giver – who is the mother in this case.

“As I write this piece, all the family members of the late child including the mother are very healthy and alive.

“The idea of a twenty one days quarantine will be quite illogical as there has been no history.

“If the child got it from the mother, the mother would first have manifested symptoms before transmission, but this was not the case.

“The child could not have got the virus through breastfeeding because the mother is neither an Ebola survivor, nor has she up to now manifested any signs or symptoms.

“The uncle of the child who donated his blood had stayed in Segbwema for over nine weeks without leaving the town, and he is also not a survivor.

“So the one million dollar question remains: HOW DID THE CHILD CONTRACT THE VIRUS?

“We are putting NERC, WHO, UNICEF, etc to STRICT PROOF!

“We want them to tell the nation the history of this mysterious one Ebola case.

“My suspicion is that either the swab result was interchanged, or the blood that was donated to the child was reserved in the blood bank, and another of the same blood group as the one donated by the uncle used on the child.

“Until the contrary is proved, we will continue to disown that result.”

So far there has been no response from the ministry of health or the National Ebola Response Centre, to the demands of the people of Kailahun district for answers, as to how an otherwise Ebola free, though sick child, could be certified Ebola positive after death.

Another question that the ministry of health needs to answer, assuming the sick child and the uncle who donated his blood to the baby were both checked for Ebola prior to the treatment and found to be free of Ebola, is whether there is evidence of criminal negligence on the part of those responsible for treating the child at the hospital.

There must be a thorough and immediate independent investigation by WHO, so that these questions are answered very quickly to regain trust.

This is necessary, if the government is to avoid a breakdown in confidence and a destruction of the community’s goodwill and active partnership, that have been responsible for keeping Ebola out of the district for one hundred and eleven days.

So far 8,547 people have contracted the virus in Sierra Leone, with a total of 3,444 deaths across the country, in the period May 2014 to 31st March 2015.

Also in that period, Kailahun district had gone one hundred and eight days without Ebola, with a cumulative total of 565 confirmed cases and 228 cumulative confirmed deaths, compared to Bombali which had achieved four Ebola free days, with 1,049 cumulative confirmed cases and 388 cumulative confirmed deaths.

Port Loko where the authorities and communities are still struggling to combat the virus, had recorded only 2 consecutive Ebola free days, 1,442 cumulative confirmed cases and 555 cumulative confirmed deaths.

Freetown the capital city has had only one Ebola free day, with 3,393 cumulative confirmed cases and 1,273 cumulative confirmed deaths.

Pujehun – a southeastern district, is continuing to champion best practice in the fight against Ebola in Sierra Leone.

The district has done a total of 124 days without a single case of the virus, with a cumulative total of 31 confirmed cases in the period May 2014 to 31 March 2015, and a cumulative total of only 16 deaths.

Echoing the words of the chairman of the Kailahun district council: “The one million dollar question remains: HOW DID THE CHILD CONTRACT THE VIRUS? We are putting NERC, WHO, UNICEF, etc, to STRICT PROOF!

“We want them to tell the nation the history of this mysterious one Ebola case.”

There must be no room for complacency, negligence or politics in the fight to kick Ebola out of Sierra Leone. The future of these young children is now in the hands of politicians.

On Monday, 6th April, 2015, the ministry of health published this statement:

“Investigation of the positive case in Kailahun is still ongoing. The public will be informed appropriately once the final report is made available.”