Six years in the past, Sierra Leone was preventing Ebola, an infectious illness that devastated the nation for nearly two years. Immediately, like most nations world wide, the West African nation is within the midst of preventing one other illness: COVID-19. The Ebola outbreak not solely killed hundreds of individuals straight, but it surely additionally worsened different well being crises like maternal mortality.
Whereas Ebola rampaged the nation, a girl’s danger of dying in childbirth elevated by an estimated 22% between Could 2014 and April 2015, based on the Ministry of Well being. With already one of many highest maternal mortality charges, the latest knowledge from the World Well being Group reveals that one in 17 ladies in Sierra Leone will die throughout being pregnant, childbirth or its aftermath.
For a lot of Sierra Leoneans, the COVID-19 pandemic has introduced again recollections of Ebola, resulting in nervousness, particularly amongst pregnant ladies, about visiting the hospital. The race is on to guard these ladies and to stop maternal deaths from skyrocketing as they did through the Ebola epidemic.
Nobody senses this want greater than Isata Dumbuya, a 50-year-old nurse who labored abroad for the UK’s Nationwide Well being Service (NHS) for 19 years earlier than returning in 2018 to her birthplace of Kono District, an jap area of Sierra Leone well-known for its diamond mines. Dumbuya runs ladies’s well being providers at Koidu Authorities Hospital (or KGH, because it’s typically referred to as).
Isata Dumbuya, a nurse who runs ladies’s well being providers for Companions In Well being in Sierra Leone. Right here, she speaks to native leaders in Kono, earlier than the COVID-19 outbreak struck, about maternal well being care out there at her ward. © Emma Minor
“You wouldn’t need to ship anybody to KGH the way it was,” she says. “Everybody has a horror story to share.” This was very true through the Ebola outbreak. “Hygiene was unhealthy and there have been no medicine,” Dumbuya mentions. “Nobody wished to go to the hospital as a result of folks stated, ‘You’ll both go in a physique bag otherwise you’ll depart in a single.’”
Over the previous few years of working for Companions in Well being (PIH), a worldwide medical nonprofit that helps KGH, Dumbuya has steadily reworked the hospital’s maternity ward, and he or she has offered coaching and mentorship to workers. High quality of care has risen, along with affected person belief and attendance.
However when information of the primary COVID-19 case reached Kono in early March, ladies started strolling away. “The hospital was cleared of sufferers inside 24-hours. Sufferers simply received up and left,” Dumbuya says.
Dumbuya is worried this newest disaster will end in widespread, extended avoidance of hospitals. As was the case through the Ebola outbreak, when there was an estimated 20% drop in hospital births, many pregnant ladies, terrified of contracting the virus at hospitals, opted for home-births with out a skilled clinician to assist if problems arose.
Dr. Marta Lado, an infectious illness specialist who helped arrange and function one of many first Ebola remedy facilities in Sierra Leone, talks in regards to the connection between COVID-19 and Ebola. “It’s sophisticated to ask folks to vary their mindset,” she says. “However it’s totally different this time. We’re extra prepared for certain.”
Because the Ebola disaster, Lado has been the chief medical officer for PIH in Sierra Leone. She is at the moment based mostly within the capital metropolis, Freetown, at 34 Navy Hospital — a facility that was constructed after the epidemic was over in preparation for future illness outbreaks. “It’s run by the military. They know learn how to defend,” Lado says of the hospital. “It’s an excellent excessive commonplace unit with biosecurity. Individuals have been skilled and drilled repeatedly.”
Dr. Marta Lado, the chief medical officer for Companions In Well being in Sierra Leone, speaks to her colleagues at 34 Navy Hospital in Freetown in regards to the well being standing and remedy path of every COVID-19 affected person. © Jon Lascher / Companions In Well being
The hospital workers used their simulation coaching to spring to instant motion when the nation’s first case of COVID-19 was confirmed in March 2020.
Studying From the Ebola Disaster
Sierra Leone’s expertise in preventing the Ebola virus accelerated the federal government’s response, too. “With Ebola, we may have saved hundreds of lives, and cash that was spent afterward, if we had tackled it early,” says Dr. Mohamed Vandi, the director of public well being safety, who’s probably the most senior well being official main the nation’s COVID-19 response. “However we had no experiences and no assets. Now, we’ve the capability and data.”
Vandi provides: “We knew it [COVID-19] was knocking at our door. My preliminary purpose was to be proactive to stop it.” Earlier than the primary confirmed case of COVID-19, Sierra Leone had already put strict measures in place, reminiscent of suspending flights, closing borders and putting in stations for folks to clean their arms and examine their temperature. This development was not seen in lots of different nations world wide.
To date, Sierra Leone has confirmed simply over 1,500 instances of COVID-19 — roughly 80% of which have been close to to Freetown, inside simple attain of 34 Navy Hospital. However as instances unfold additional afield, Vandi has instructed that remedy facilities be arrange throughout the nation. He says the motivation behind that is to ease sufferers’ fears about lengthy ambulance journeys. Through the Ebola epidemic, many individuals died in transit to distant remedy amenities earlier than receiving the care they desperately wanted — a reminiscence that also haunts right this moment’s residents in Sierra Leone.
“Now we have seen a discount in ladies on the hospital, a discount in ambulance calls and a discount in referrals from different well being facilities,” Lado says. However medical workers are combating this with compassion. “Nurses are the roots of what we’re doing right here,” she provides. “They don’t hesitate about spending as a lot time as they will with sufferers. They do a variety of psychosocial help and engagement.”
Dumbuya mentions that her focus is on encouraging sufferers. “Now we have been out speaking to ladies and leaders in the neighborhood about what’s occurring world wide and to emphasize that hospitals are nonetheless open for enterprise,” she says. “We try to unfold the phrase that COVID could be very totally different to Ebola. We are able to get to folks faster, isolate them and provides remedy.”
Dr. Marta Lado prepares to deal with COVID-19 sufferers at 34 Navy Hospital. © Jon Lascher / Companions In Well being
It’s too quickly to foretell the long-term influence of the COVID-19 disaster on maternal mortality in Sierra Leone. Nonetheless, consultants are hopeful that the county’s fast, environment friendly response to the outbreak, coupled with the availability of counseling for sufferers and communities, will go a good distance in making ladies really feel assured about persevering with to entry maternal providers — a mindset that was gravely missing through the Ebola outbreak.
At KGH, triage programs are firmly in place to separate COVID-19 sufferers from these looking for routine well being providers. Dumbuya’s precedence now, alongside together with her colleagues at PIH and KGH, is to stop well being care requirements from dropping as they did through the Ebola disaster and to proceed preventing maternal mortality.
“Dying in childbirth is an ongoing emergency in Sierra Leone,” Dumbuya says. “The care we provide is meant to save lots of ladies’s lives, but in addition to enhance the maternal journey in order that they return.”
*[A model of this text was initially printed by the International Well being Information Wire.]
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