Ebola blog: Families in quarantine
Plan's Ebola work in West Africa includes supplying quarantined families with food and household goods. It's vital work, but poses many challenges, as Calvin Laing saw first-hand. He is currently in Sierra Leone, helping to coordinate our Ebola response.
Tuesday 20 January
I’m now in Freetown, Sierra Leone’s capital city. My head is spinning with new information as I try to identify priorities, make contact with key individuals and get a real understanding of all our Ebola work in the country.
A critical issue is to finalise standard operating procedures (SOPs) for the decontamination of homes. This vital work is not easy. Plan has been the only organisation formally coordinating decontamination of homes, delivering chlorine disinfectant and sprayers to District Health Management Teams. Cleaning houses in town is more feasible but in rural areas where homes have mud floors it is a problem. They can't be wiped clean. So the best we can do is to spray them with chlorine, which is far from an ideal solution. But we continue to do the best we can.
Life after Ebola
The rest of the day has been spent looking forward. We must think about life after Ebola. For all the destruction that the virus has caused, and continues to cause, there are opportunities. Can we make the best of the new emphasis on good hygiene practices like hand washing, and can the way communities have organised themselves to help establish community systems to manage Ebola be transformed into a longer term, community-based health referral system, and so on?
These are questions the team in Sierra Leone are now thinking about, without losing sight of the fact that this emergency is far from over.
Wednesday 21 January
I was in Mabela today, which is a community in Freetown, where I saw supplies being distributed to quarantined homes.
When a case of Ebola is confirmed, contact tracers are sent to identify all those the patient has been in contact with. From this, a list of homes to be quarantined is drawn up and passed on to the local command centre. In turn, this is passed on to Plan and other NGOs we’re coordinating with.
Our job is to provide these homes with food and household items, so they have everything they should need for the duration of the 21-day quarantine period.
Supporting quarantined homes
Plan International started doing this work in December. In Freetown and the surrounding Western Area, we’re planning to supply 6,000 quarantine kits, and we’ve distributed about 5,000 so far. The package we provide varies from area to area, and has developed over time. Here’s a breakdown of what each household typically receives:
Basmati rice 1 bag
Luncheon meat 5 tins
Charcoal 1 bag
Tea 1 box
Pure water 10 bottles
Ovaltine 1 tin
Onions 1/4 bag
Smoked fish 1 dozen
Salt 1 packet
Dettol disinfectant 1 bottle
Sugar 2 packets
Medicated soap 2 pcs
Beans 15 cups
Hand sanitizer 1 pcs
Vegetable oil 2 litres
Coal pot 1 pcs
Palm oil 2 litres
Kettle 1 pcs
Powdered milk 1 tin
Phone credit 100,000 Leones
Butter 1 packet
Jerry cans 4 cans
Flavoured drink 6 packets
Daily life in Mabela
Mabela is a slum area, right on the bay in the north of Freetown. We approach down a narrow street, lined with market stalls. The market seems to go on indefinitely – and pretty much anything you could want is on sale, including, tellingly, a lot of bleach and chlorine.
The place is thronging with people, and behind the market stalls lie tightly packed housing. Our car stops and starts as we try to get through the crowd. The streets continue to close in on us as we get closer to the point for today’s distribution.
Getting the supplies where they’re needed
The infrastructure in this densely populated area is pretty much non-existent; there is no drainage and little running water. I’m with Anthony, a Plan Project Manager, who tells me that it’s not uncommon for up to 10 families to live in the same compound in close confines. It’s not hard to see why this area has been an Ebola hotspot. It’s also clear why the team doing the distributions have been telling me this is a difficult area to work in – it takes a long time to travel a short distance through the crowds, and trying to manoeuvre a lorry through the narrow streets is no easy task.
When we arrive, the lorry has just started unloading. Sheik, who works as the Plan International contact point for the area, is there with YACAN, our local charity partner, which runs the distribution. Today, we’re providing supplies for 60 households, which are all close together, down a narrow alley.
Where we can, we drive up to the household and deliver the items directly to the home, with a cordon in place. But the lorry can’t get there. It has parked as close as possible and the team has started to arrange packages into 11 piles for the first 11 households.
Four policemen and soldiers are present. They cordon off the houses under quarantine and the unloading area – a more-or-less impossible task in the busy market street. A large crowd gathers and there’s a lot of shouting and complaints that we’re blocking the street up, as people are trying to get about their business. But all things considered, the atmosphere is lively, rather than threatening. As the unloading continues, a Red Cross convoy, sirens on, struggles to get past – it’s a hearse, carrying another suspected case of Ebola.
Sheik and the team at YACAN have been running distributions over the past few months. I ask them how they have found it. They say it’s all gone pretty well, but they’ve encountered some conflict in communities.
Understandably, quarantine is a scary thing, and not everybody wants to cooperate, particularly when non-quarantined neighbours are needed to help deliver supplies.
Once the lorry is unloaded, community volunteers, all of whom know the affected households, take the supplies down the narrow alley and up to the quarantine cordon near the houses. Once they have left, those in the quarantined homes are able to come out and take the kits inside.
It’s a pretty horrible process – from my own perspective, it seems fairly dehumanising. I feel for the families who have to go through it. But I don’t know whether there’s a better option at this stage. We haven’t seen an outbreak of Ebola like this before and everyone has had to learn so quickly. We’re continually improving the quarantine process, and for sure, at least Plan International delivering these supplies helps make quarantine more dignified and bearable for the families.
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