Health crisis in West Africa - and it's not Ebola

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Health crisis in West Africa – and it’s not Ebola

By Chelsea Radler


Ambulances – too old to use - at the Tubmanburg General Hospital in Bomi County, Liberia. (CDC Global under a Creative Commons Licence)

The old diesel generator in the only hospital in Moyamba District turns off again. There’s only enough fuel for it to run for four hours, twice a day.

Here in the south of Sierra Leone, there are no incubators for early babies, no oxygen for patients, no surgical equipment – and no power to run them. The world was trying to get Ebola cases to zero, but at the same time, another health emergency has been growing in West Africa. Because resources and interest have moved away from general healthcare, many more people are dying of other illnesses than they were from Ebola.

Doctors of the World reported that, in one region of Sierra Leone, as many people have died in four months as in one year before. Forty per cent of the dead are children younger than five. Why? – not enough general care for conditions that can mostly be cured.

‘When people needed the healthcare system in Sierra Leone most, it had to help with Ebola,’ says Dr James Elston who wrote the report. ‘Many many people are dying from causes we can avoid.’

At same time as the risks of Ebola got less, other threats to public health increased. There is a lot more measles, polio and cholera. The rainy season in June will bring a lot more malaria. And the bad roads make it more difficult to get treatment. Teenage pregnancy and TB and HIV are also increasing.

‘Any of these could be a catastrophe for a vulnerable population with a very weak health system’ James Elston says.

Why are people in Sierra Leone getting sicker? One reason is because they go to health centres less. There are up to 73 per cent less people at health centres than before Ebola. People with malaria, malnutrition, HIV etc are afraid of getting Ebola from doctors or at hospitals.

Treatment of pregnant women is half what it used to be at health centres. This increases the risk of complications and harm to mothers and children. Malaria treatment to children has decreased by 80 per cent.

‘What happens to children with severe malaria whose parents are too afraid to get treatment? Many of them die,’ says Elston. ‘This is the same in the rest of the country. In areas with more Ebola, it’s even worse.’

Nowhere has enough healthcare facilities and equipment. In Moyamba, they can only use two ambulances for cases that are not Ebola. Health facilities don’t have clean water, a consistent power supply, basic equipment like x-rays or essential medicines for common conditions.

‘We lose most of our premature babies because there are not enough incubators in the only hospital we have,’ one maternity nurse in Moyamba says.

Elston says: ‘This is shocking. With almost nothing to look after new babies, a hospital is not a hospital.’

The healthcare workers are afraid and do not have equipment. Many of them were taken from TB and malaria teams to fight against Ebola. At the same time, local health volunteers say the international Ebola teams made them feel they are not important. Many of these workers left their jobs and it is difficult to find new workers.

There are not enough doctors, not enough equipment and medicine, and not enough trust between patients and healthcare workers. So this health crisis is urgent. And it means a second outbreak of Ebola is more likely.

‘It’s like we need to use both hands to stop the bleeding from a wound, while a bear walks up behind us. Sierra Leoneans cannot wait for zero Ebola cases before they get basic healthcare,’ says Gareth Walker, manager of Doctors of the World’s International.

The report – to decide which health issues are most important in the area – was based on work that included 40 interviews, eight focus groups, site inspections and data collection. It shows that the health system in Sierra Leone is in a terrible state and that we need to invest money immediately in healthcare.

‘People did not do enough to support the day-to-day health system during the Ebola crisis. So we must do it now,’ says Elston. ‘Blood tests, for example, cost very little, but first they need the machines to do them. A lot of basic equipment immediately would have a very big effect.’

NOW READ THE ORIGINAL: (This article has been simplified so the words, text structure and quotes may have been changed).