EMERGENCY PREPAREDNESS, IS KENYA EVER READY?

The year 2014 was one characterized by terror across the entire world. The worst ever recorded Ebola epidemic lit up like wildfire and spread unimaginably. Everyone was shaken as the disease crossed borders without fear or favour and death was recorded even in the traditionally safe havens.

With the index patient being an 18-month old baby thought to have been infected by bats, hailing from a small rural village in Guinea in December 2013, it took three months for the diagnosis to be established. It cost 29 deaths out of 49 confirmed cases for the World Health Organisation to declare it an outbreak.

In no time, the outbreak had spread to the neighbouring Sierra Leone and Liberia and by August 2014, World Health Organisation had stepped it up to a level three emergency, designated Public Health Emergency of International Concern (PHEIC). Smaller numbers were recorded in other countries such as Nigeria and Senegal but the world took notice when the United Kingdom and the United States of America reported cases.

This was one epidemic that raged on for so long and was so harsh that it stretched the international emergency responses to the hilt. The world stared the terror of being overwhelmed in the face. All units with capacity for emergency response were drawn in but they were still overwhelmed. Communities were fully involved in the fight but it was a daily struggle to keep going against the menacing monster.

It took more than two years before the Guinea, the last of the three hot spot countries, finally declared that it was Ebola-free. It had been a ravaging two years. The reality that the world was not fully prepared for an epidemic of such magnitude was fully evident. Discovery of new hot spots having to go for days before organized response could be set up; telephone hotlines that could not offer any help as there were no more units to collect the dead or ambulances to collect the suspected cases to the health facilities; health care workers going unpaid for weeks despite risking their lives to care for the sick and dying; all these were clear indications that emergency preparedness was way below par.

The World Food Programme, the most technically savvy of the United Nations programmes, had to step in and airlift ambulances and hearses to save the day, while awaiting the fleets in the high seas to arrive. The Medicens San Frontiere were stretched beyond limit. The World Health Organisation had to pay salaries of health workers when the governments were overwhelmed to avert health worker strikes in a situation that was already desperate.

By August 2016, the world breathed a collective sigh of relief. Guinea, Liberia and Sierra Leone set about rebuilding their countries after the ravages of the epidemic. The international agencies moved on to the debriefing stage of emergency response. The press went back home and the world distanced itself from the horror.

In this lull we have wrapped ourselves in, local press is not bringing to light the fact that as a country, we are still at risk. International press has been highlighting the happenings in the Democratic Republic of Congo (DRC) but we refuse to pay attention. The Ebola war is still ravaging the eastern part of DRC, with a major threat to Uganda and by extension, Kenya. The World Health Organisation statistics currently stand at 216 cases reported from 4th May to 15th October 2018. Of these, 181 are confirmed and 35 are probable. The death toll stands at 139, with 104 being confirmed and 35 are probable.

Why then are we so silent? Perennially, Ebola outbreaks have always occurred in small isolated rural villages where media coverage is scarce. The isolation of the epicenters of outbreaks has served to also provide a physical barrier to spread of the outbreaks. The main reason the 2014 to 2016 outbreak was so vocally discussed was in part by the sheer magnitude of the outbreak: 28,600 confirmed cases and 11,325 deaths. In addition, this was the first time the outbreak swept across urban cities that are heavily populated with imminent contact spread.

The current epidemic is much more silent as it involves small rural communities that have poor access and in addition, these are regions that are also ravaged by war. The insecurity of the area makes it difficult for journalists to cover the stories in a more wholesome manner. It has also not crossed international boundaries hence despite being a level three emergency, it is not yet a PHEIC.

Our borders are still porous, our airport screening became a thing of the past, our truck drivers are still plying the route without being aware of the imminent danger they are in. Our health workers are not primed to have a heightened sense suspicion in the event a patient was wheeled into the emergency room.

Our emergency response department is not doing Kenya a favour. The public needs to know that the threat is still present, even if not imminent. Our Port health team needs to pull up its socks at our points of entry. And our health workers are in need of constant training and retraining to be ready at all times. Emergency preparedness is not something we can afford to take for granted when it comes to life threatening epidemic diseases such as Ebola!