How Will Sierra Leone Fight COVID-19 and Maternal Mortality?
Six years in the past, Sierra Leone was preventing Ebola, an infectious illness that devastated the nation for nearly two years. Right now, like most international locations all over the world, the West African nation is within the midst of preventing one other illness: COVID-19.
The Ebola outbreak not solely killed 1000’s of individuals instantly, nevertheless it additionally worsened different well being crises like maternal mortality. Whereas the Ebola virus rampaged the nation, a lady’s danger of dying in childbirth elevated by an estimated 22% between Might 2014 and April 2015, in accordance with the Ministry of Well being. With already one of many highest maternal mortality charges, the latest knowledge from the World Well being Group exhibits that one in 17 girls 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 reminiscences of Ebola, resulting in nervousness, particularly amongst pregnant girls, about visiting the hospital. The race is on to guard these girls and to stop maternal deaths from skyrocketing as they did in the course of the Ebola epidemic.
Understanding Sufferers’ Fears
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 girls’s well being providers at Koidu Authorities Hospital (or KGH, because it’s typically known as).
“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 in the course of the Ebola outbreak. “Hygiene was dangerous and there have been no medication,” Dumbuya mentions. “Nobody needed to go to the hospital as a result of folks stated, ‘You’ll both go in a physique bag otherwise you’ll go away 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 she or he has supplied coaching and mentorship to employees. 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, girls started strolling away. “The hospital was cleared of sufferers inside 24-hours. Sufferers simply bought up and left,” Dumbuya says.
Dumbuya is anxious this newest disaster will end in widespread, extended avoidance of hospitals. Through the Ebola outbreak — when there was an estimated 20% drop in hospital births — many pregnant girls, scared of contracting the virus at hospitals, opted for home-births and not using a skilled clinician to assist if issues arose.
Dr. Marta Lado, an infectious illness specialist who helped arrange and function one of many first Ebola therapy facilities in Sierra Leone, talks concerning the connection between COVID-19 and Ebola. “It’s difficult to ask folks to alter 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 present primarily based within the capital metropolis, Freetown, at 34 Army Hospital — a facility that was constructed after the Ebola epidemic in preparation for future illness outbreaks. “It’s run by the military. They know defend,” Lado says of the hospital. “It’s a brilliant excessive customary unit with biosecurity. Folks have been skilled and drilled constantly.”
The hospital employees 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 1000’s 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 essentially the most senior well being official main the nation’s COVID-19 response. “However we had no experiences and no sources. Now, we now have the capability and information.”
Vandi provides: “We knew it [COVID-19] was knocking at our door. My preliminary goal 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 scrub their fingers and examine their temperature. This development was not seen in lots of different international locations all over the world.
Thus far, 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 Army Hospital. However as instances unfold additional afield, Vandi has instructed that therapy 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 therapy amenities earlier than receiving the care they desperately wanted — a reminiscence that also haunts at present’s residents in Sierra Leone.
“Now we have seen a discount in girls on the hospital, a discount in ambulance calls and a discount in referrals from different well being facilities,” Lado says. However scientific employees 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 lots of psychosocial help and engagement.”
Dumbuya mentions that her focus is on encouraging sufferers. “Now we have been out speaking to girls and leaders locally about what’s happening all over the world and to emphasize that hospitals are nonetheless open for enterprise,” she says. “We try to unfold the phrase that COVID may be very totally different to Ebola. We are able to get to folks faster, isolate them and provides therapy.”
It’s too quickly to foretell the long-term affect of the COVID-19 disaster on maternal mortality in Sierra Leone. Nonetheless, consultants are hopeful that the county’s speedy, environment friendly response to the outbreak, coupled with the availability of counseling for sufferers and communities, will go a great distance in making girls really feel assured about persevering with to entry maternal providers — a mindset that was gravely missing in the course of the Ebola outbreak.
At KGH, triage programs are firmly in place to separate COVID-19 sufferers from these in search of 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 in the course of 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 girls’s lives, but in addition to enhance the maternal journey in order that they return.”
*[A version of this article was originally published by the Global Health News Wire. Updated: July 7, 2020]
The views expressed on this article are the creator’s personal and don’t essentially replicate Truthful Observer’s editorial coverage.