Famiglia in quarantena

Apart from the deaths that have taken place throughout Sierra Leone, all the schools at all levels in the five districts have been closed for an unspecified time. In these areas, the school programmes are broadcast by radio and are used for at least one hour a day in the primary and secondary schools. This allows the guarantee of a minimum of continuity in education without there being the physical contact of students. The closing of schools has had as a consequence the non-payment of salaries to the majority of teachers and to all school personnel.

Some private and state hospitals have been closed, with the exception of clinical departments, paradoxically in an attempt to reduce the cause of contamination by the virus. People are losing confidence in hospital institutions and prefer to treat themselves in their own homes. The result of this has been an increase in the number of people who die not because of Ebola but because of other endemic infections.

Five districts are completely isolated and mobility is allowed only from 9.00 to 17.00. This has had a great impact on the economy as a whole. People cannot transport their products – above all basic foodstuffs – because not all public vehicle guarantee a service and private vehicles need a special permit.

Families in quarantine are also isolated. Their houses are surrounded and guarded by soldiers. Nobody is allowed to leave the perimeter. As people in quarantine cannot work, they cannot earn anything. Visitors and neighbours are authorised to enter into contact with them at a prescribed distance of not less than two metres. However many of them, because they are afraid, avoid even this minimal contact.

These people in quarantine are practically incommunicado. Although the period of quarantine has been fixed at a scientific level at 21 days, for some people who are suspected of having the infection this has been extended to three months given that during this period of isolation they had contact with some of their relatives who displayed some symptoms of the disease.

The supply of basic goods (food and hygiene) is quantified on a regional basis but the quantity is not sufficient. During the twenty-one days of isolation the following are distributed: rise, onions, chicken meat, manioc and non-food products such as kits for hygiene, cooking utensils, and kits for sleeping (one for each member of the family).

 Many children have become orphans given that their parents and relatives have died because of Ebola. One family infected with the virus in a village of Binkolo, Makeni, lost 17 members in the space of two weeks. The children are placed in a reception centre and kept under observation. Those who test negative for the virus are put in a centre and placed in the care of a social worker. They are not authorised to return home but their relatives want to look after them and go against the decisions of the government which has established that these orphans should be sent to an orphanage.

There is a good percentage of survivors (781 as of 28 October) which is 21%. These survivors are rehabilitated and sent back to their communities with suitable discharge documents. It has been established that each survivor has a zero possibility of being infected again and can see himself or herself as being immune to the virus. Their blood has been used for transfusions with other infected people. However their return home generates fear in the people of their communities, just like the stigma that lepers had in ancient times. Isolation and then rejection by the community sorely tests the spirit and the mental balance of these people, with the risk of a weakening of their defences and their exposure to other infections or traumas.

Famiglia in quarantena

The medical staff are exposed to a high risk of contagion. Many of them died during the early appearance of Ebola. There are various reasons for these deaths in health-care terms: the violation of safety protocols in medical procedures; the lack of early screening in people hypothetically infected before they enter areas of hospitals where there are often other kinds of patients; a lack of equipment for individual protection; and the absence of suitable training and knowledge about specific protocols for infectious diseases.

On the other hand, with the closure of most of the hospitals many health-care workers, being frightened, have stayed away from work by asking for a period of holiday. Whatever the case, all of them are not receiving their salaries. Many of them are afraid of going back to their hospitals. Those who stayed to work in their hospitals (and this is the case of the Holy Spirit Hospital of Makeni) are paralysed by fear and this makes them less effective in their work. They need human and psychological support – for example formation and training courses about the new protocols as well as accompanying by experts.

Members of the Church (priests, religious and lay people) are especially under pressure at a psychological level. They admit that they are afraid. Some congregations have closed their missions temporarily. However, many continue their battle against the spread of Ebola. The diocese of Makeni has six of the fifteen districts in Sierra Leone. Most of these neighbourhoods have been heavily hit by the epidemic. The diocese has activated a Diocesan Task Force (DTF) as a response to Ebola. It is made up of GPIC, Caritas Makeni, Unimak (university), the Holy Spirit Hospital and other religious. Hitherto, the DTF has achieved its first objective, that is to say the mobilisation of the parishes and the organisation of its own work groups. The DTF has held seminars (prevention, mobilisation, surveillance and monitoring) in 25 parishes for the formation of parish priests and the leaders of the community.

In support of the action of the government they have also distributed food products and basic products to families in quarantine. There are obviously failings at an organisational level: financial support at a parish level, capacity for organisation, the management of projects, the monitoring of activity, the mobilisation of volunteers, the logistical structure (handling of materials, the organisation of transportation, and the distribution of supplies.

To be continued…

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On the cover a photograph sent to us by Anita Ennis, the Vice-President of the Lay Camllian family, who was sent to Mekeni. In the photograph the laundry of the Holy Spirit Hospital.