Here’s one of the most under-reported stories in Sierra Leone’s Ebola saga – and potentially one of the most impactful.
“The chairman of the Council of Paramount Chiefs, PC Charles Caulker has said that within the next two months [paramount chiefs] will ensure that Ebola will become a thing of the past.
“He made this statement at a meeting with the Deputy Minister of Local Government …. at the Bo District Council Hall on December 3.” (ExpoTimes – Dec 6)
How can Chief Caulker make such a bold statement? He can because he has done just this in his own Bumpeh Chiefdom. He’s sustained no new Ebola cases now for nearly 60 days, despite Ebola present all around in neighboring chiefdoms.
Why have more paramount chiefs not had a greater impact to date in eliminating Ebola? A clear game plan was needed describing the few high impact activities to control Ebola. The chiefs have pooled their collective experience in facing Ebola and defined this plan through the National Council of Paramount Chiefs (NCPC). They call it “Breaking the Chain of Ebola Transmission.” The plan leverages the chiefs’ unique responsibilities and local authority at the village and neighborhood level to stop the virus from being transmitted person to person.
The other gap has been lack of funding to implement the necessary activities in all chiefdoms. On December 3, the government finally addressed this with $1.2 million in funding for the 149 chiefdoms across the country provided by the World Health Organization.
The Spectator newspaper reported: “The Chief Executive Officer (CEO) of the National Ebola Response Centre (NERC), Major (Rtd.) Alfred Paola Conteh, on Wednesday 3rd December, 2014, disclosed that US$1.2 million has been sourced by his office for the 149 Paramount Chiefs in the country. … the CEO maintained that Paramount Chiefs are very instrumental in the fight against Ebola.
The money, according to Major (Rtd.) Alfred Paolo Conteh, is meant to get the Paramount Chiefs up and running in their continued fight against the Ebola disease …”
The National Council of Paramount Chiefs (NCPC) Chief Caulker leads developed a concept paper that outlined steps he and other paramount chiefs have used to keep Ebola out of their chiefdoms. The paper serves as a template for each chiefdom to enact byelaws on this chiefdoms use as their local “law.”
The NCPC used the paper to co-author a “Breaking the Chain of Ebola Transmission” document with the Ministry of Local Government and Rural Development (MLGRD). Changing long held beliefs and customs on burials and caring for the sick has stymied ending the Ebola epidemic. MLGRD Minister Diana Konomanyi-Kabba said, “solutions to end Ebola need to be fashioned out of and implemented within the framework of local leadership.” (Awareness Times)
In a second meeting last week in Kenema launching this initiative, the Kenema mayor declared Ebola eliminated from Kenema District. Two months ago Kenema city was plastered in the news as one of two early epicenters out of control, with hospitals overflowing and bodies in the street. Mayor Keifala said, “they had encouraged local authorities to form taskforces in their respective chiefdoms to coordinate activities for the eradication of Ebola.” Politico – December 6
Deputy Minister of Local Government and Rural Development Hadiru Kalokoh, who came to Kenema to launch the paramount chiefs’ project there said, “his government recognised the role of Paramount Chiefs in ensuring development in their localities. He said the president was convinced that the chiefs were the answer to the fight against Ebola.”
What will paramount chiefs actually do to eradicate Ebola from their chiefdoms? They are leading a four-prong approach:
- Daily door-to-door home visitations by village headmen to check for sick people and isolate them from the rest of the village. Immediate calls to district health teams will initiate Ebola testing to confirm and move cases for treatment.
- Safe burial procedures with immediate reporting of all deaths to chiefdom authorities. Paramount Chiefs have the authority to take custody of dead bodies in their chiefdom and ensure Ebola testing and safe burial teams are arranged.
- Checkpoints at chiefdom borders manned 24/7 to monitor all movement in and out, and turn away people who are not residents or who appear sick. Checkpoints are strategically placed for vehicle, river and foot traffic.
- Continuing sensitization of residents to reinforce Ebola symptoms and actions to protect themselves.
$1.2 million for this program may sound like a lot of money. But divided among 149 chiefdoms, it averages only $8000 per chiefdom. This is far less to achieve far more than funding for large NGO programs to “sensitize” the population. Short one-time visits to towns and villages by NGO staff unfamiliar with the people will not change deep seated behaviors. Many inaccessible villages will be missed.
The paramount chiefs’ plan will not alone be the silver bullet to end Ebola. It has to work in concert with government services to isolate, transport and treat Ebola cases. More hospital beds are still needed. But it’s a major component that’s been missing to date. With Ebola so widespread across the country, a systematic way to identify any and all sick people and dead bodies, and immediately isolate them from the rest of the community has been needed. It’s also the most effective way to influence safe behaviors countrywide using known and trusted community leaders and repeated contact.
This is why the chiefs call their plan “breaking the chain of transmission.” It goes to the source of the problem at the community level and stops further transmission. Ebola started locally in a village. It will only end with comprehensive local action.
With Ebola now raging in urban centers in the west and north, the whole country remain at-risk. I asked Chief Caulker what can be done to control these areas. Handle them in the same way as a chiefdom, he said.
Divide a city like Freetown into sections and assign responsible section leaders to coordinate activities like chiefdom section chiefs. Further divide sections into neighborhoods for village equivalents. Use neighborhood leaders to do the daily home visitations and respond to suspected Ebola cases and deaths.
Sounds simple. But it’s simple, strategic plans that usually works. Chief Caulker, other Paramount Chiefs and Kenema District have shown what does works. With traditional leaders now fully engaged and funded, a major proven strategy is moving into place. Hopefully, the country can soon call Ebola a thing of past.
Sherbro Foundation is proud to have provided early funding for Chief Caulker’s Bumpeh Chiefdom Ebola program. It saved lives and allowed them to demonstrate the program’s effectiveness.
Executive Director, Sherbro Foundation