Thursday, March 31, 2016

The City That Doesn't Touch Feb 26, 2015844 views87 Likes8 CommentsShare on LinkedInShare on FacebookShare on Twitter I work in Freetown, Sierra Leone, a city that doesn’t touch. Try it yourself today – try not touch anyone, all day all evening. Try to resist shaking hands at work, or avoiding the warm hug from a friend, the casual arm to guide a companion in the correct direction. Experience the awkward feeling of suddenly not holding hands with your loved one. Early evening on Sunday I sat on the seafront at Freetown, watching the sun sink into an Atlantic horizon. The shops, restaurants and bars, by presidential decree under the State of Emergency, had closed an hour earlier. Dozens of young couples were out walking along the shore, but such is the pervasive caution that none were arm-in-arm, hand-in-hand or kissing. No presidential decree has said as much, but touch is on hold in Freetown. The police, army or militia don’t need to enforce this no touching policy. In Freetown, to walk hand-in-hand with your lover along the beach marks one out as reckless and selfish, perhaps even a vector. The way to fight this Ebola plague, by reducing human contact to a cold, logical minimum, has meant that social interaction has become anti-social. Social interaction has been driven into the private sphere. Tactile affection is expressed behind doors, away from the prying eyes of those ready to judge, tut and gossip. The response to the Ebola threat The sheer organisational skills and high-tech resources that have been deployed to deal with Ebola are phenomenal. In 2013, pre-Ebola, the country had six beat-up ambulances for the entire country. At last count, the number of ambulances was in the hundreds. Before Ebola, the health infrastructure in Sierra Leone was either non-existent or collapsing, now the country has some of the most sophisticated medical clinics in the world. Helicopters criss-cross Freetown day and night, ferrying first-responder teams and transferring patients. Army and police roadblocks are around every corner, checking your temperature for early signs of the disease. This is a city under siege and at war. Yet the Sierra Leoneans, under a very able joint civilian/military leadership, retain hope. Privately held fears remain just that, private. The citizens of Freetown mix an effective combination of stoicism and fatalism to ensure that extraordinary discipline, behavioral change and tedious commitment is adhered to. This is a war with millions of people on the front line. This citizens’ army is equipped only with thermometers, water, chlorine, self-restraint and repetitive focus. Co-operation and focus in time of crisis Albert Camus in his allegoric novel the ‘Plague’, said: “once the faintest stirring of hope became possible, the dominion of plague was ended” and it’s that very hope that ensures defeat for Ebola is the most likely outcome of this war. And what an extraordinary coalition has been assembled. On any given day my own colleagues will find themselves working alongside Sierra Leonean nurses, Cuban doctors, British soldiers, Chinese army medical squads, district hereditary chiefs, Kenyan tropical health epidemiologists, virologists from the Centre for Disease Control in the USA and the alphabet soup of letters that is the UN. Ebola will be defeated and what will be left is a country that is badly wounded because of its sacrifice. Children have been uneducated for a year, their schools closed in an effort to contain the spread. The previously impressive economic recovery of the country is in reverse. Roads, energy and communications infrastructure projects across the country stopped months ago, laying off thousands of workers. All retailers and markets are on significantly reduced hours; farmer access to markets is curtailed; entire districts quarantined; travel restricted; cinemas and theatres closed; borders sealed; exports halted; beaches out of bounds; public parks locked; competitive sports postponed; youth clubs shut; taxis off the street by dark. In short, the country has cooperatively ground itself to a halt. The unknown scale of what was emerging We might well forget that worst-case scenario forecasts have partially come true. Some predictions suggested that Ebola would, for the first time in its 37- year history, arrive into a city. It happened. It was suggested that from a capital city the fight against Ebola would likely become worldwide. It didn’t. There were some isolated exceptions - Spain, the US and UK - but Sierra Leoneans, with technical and financial support from the international community have contained the horrifying spread of this disease not just in Freetown, but prevented its existentialist export to the world. Strategists could learn a lot from this experience; a study of the impact of the omnipresent relentless marketing campaign to get people to change their behavior to stop contracting and spreading the disease, the singular adherence to an approach that looked doomed from the start but all available information said would work, the leadership and confidence publically expressed by political, civic and medical leaders to ensure calm and social structures held up and the constant reallocation of resources to target outbreaks that popped up unpredictably around the country. Impressive public health campaigns have been done before; clearing Havana of Malaria in the 1890s and Panama of Yellow fever in early 20th Century. Both of those tasks were considered impossible and done with a much more pliant population. What this campaign against Ebola has shown is what clear strategic leadership in a modern context can achieve on a massive scale, ensuring that more than 6 million people are pulling on the same team.
Killian Forde Killian Forde Test Test Test I think I will start blogging again.