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Chatham House

Ghana avoided the worst of the Ebola outbreak several years ago and this is largely due to efforts outside the country.

Ghana’s ex-president, John Mahama, may have prepared for a possible Ebola outbreak but Ghana would not have been able to contain it at the time without a scar to show for it.

I was in Monrovia, Liberia working as a journalist in 2014 when Ebola tore through Guinea and Sierra Leone. A Liberian colleague with another news organisation reported that a motorist had brought in an Ebola patient from Guinea. This claim, as expected, was denied by the Ellen Johnson Sirleaf-led government. Months later, thousands of Liberians were infected and many died over a period of time because of the irresponsibility of the government.

While my major concern at the time was my safety, I was equally troubled by how Ghana was going to handle an Ebola outbreak considering how lethargic our governments have been in the past. In this article, I will discuss how John Mahama tackled the Ebola crisis in terms of preparation, logistics, and commitment, concluding that Ghana did not record a single case, not because of the efforts of the government but rather the aggressive measures taken by our neighbours such as Ivory Coast.

Preparation

Preparation for an outbreak is an important barometer of the commitment of any government. In fact, our elders say that when your neighbours beard is on fire it will serve you well if you can draw closer to a well. Perhaps in the event yours also catches fire you will be able to take a long dive into the water. It appears our governments are yet to learn anything from this traditional injunction.

I returned to Ghana in May 2014, to meet a nation and its citizens disappointingly unprepared for the Ebola virus. Nothing was going on by way of public education. It took the Mahama-led government surprisingly ten months to come out with a national plan to combat the disease. The government announced the “Ghana Preparedness and Response Plan for Ebola Viral Disease” in August 2014 after recognising the enormity of the challenge ahead.

With an estimated cost of over $4 million, the key highlights of the intervention were: screening at points of entry; isolation of suspected, probable and confirmed cases; diagnosis and confirmation of cases; case management; contact tracing; burial and safe disposal of death from Ebola virus disease; psychosocial support for the cases and the relatives; and, social mobilisation.

As was predicted, the international community raised several concerns about the slow implementation of the plan. Jim Bever, a Foreign Service Officer with USAID wrote that: “We were concerned that two or three levels down, the government of Ghana did not seem to share our sense of urgency or that of its official donor group (which USAID chaired).” He said the pace of the plan’s implementation was slow and that knowledge of Ghanaians about Ebola and the “cultural and behavioural changes that would be needed to contain a possible outbreak was still minimal.”

The other concern was the preparedness of the security agencies for possible “massive investigations, quarantining and riot control.” The verdict of the international community and a majority of Ghanaian experts with regards to the preparedness of the government of John Mahama for the Ebola virus was damning and damaging, but it was the truth.

“We and our fellow assistance donors, along with international security and health experts, judged that, so far, the preparedness actions Ghana had taken were necessary but not yet sufficient for its own protection,” Mr. Bever concluded. It took a series of meetings involving USAID, experts from the Centers for Disease Control and Prevention (CDC), and the Nigerian epidemiological team to get the Ghanaian government to appreciate the enemy the three-affected countries in the sub-region were dealing with. The government was later to establish an Inter-Ministerial Task Force on Ebola to spearhead the campaign.

Logistics and commitment

Mr. Mahama’s government went into action after it understood the need to prepare its citizens for a possible Ebola outbreak. The government procured about 10,000 protective clothing suits for medical personnel and three Ebola Isolation Centers were built to handle the outbreak. A life insurance package was announced for health workers to motivate them to help in addressing the issue in the event of an outbreak. The government also set up a rudimentary screening and temperature testing at Ghana’s airports and official border crossings. Then serving as the head of the Economic Community of West African States, Mr. Mahama agreed to a proposal by the United Nations to set up its regional response logistical base – UN Mission for Ebola Emergency Response (UNMEER) in Accra to service the three most affected countries.

The government in collaboration with the World Health Organisation (WHO) and Médecins sans frontières (MSF) trained health professionals and retooled hospitals in the face of a possible emergency outbreak. Mr. Mahama and his team later rolled out other measures but they were not enough to prepare Ghana for a possible outbreak.

The critical role played by Ivory Coast and airlines

The aggressive campaigns undertaken by the Ivorian government and airline companies should be praised and credited for the safety of Ghanaians. Ivory Coast announced a border closure with its neighbours to prevent the spread of the Ebola virus at the same time that Mahama’s government unveiled the government’s action plan. In fact, the French-speaking country had banned flights from Liberia, Guinea, and Sierra Leone days earlier. Other countries such as Gabon, Senegal, Cameroon, and South Africa were to take similar measures. Addressing ECOWAS Health Ministers in Accra, Mr. Mahama said reactions to the Ebola outbreak, including border closures and flight ban, were rather having negative consequences in isolating and worsening the situation of the affected nations.

Similarly, the WHO described the measure as counter-productive. But three years later the measure taken by Ivory Coast proved useful and most effective.

Also reacting to the outbreak, airline companies banned flights to Liberia, Guinea, and Sierra Leone. I remember visiting a travel agent in Monrovia to get a ticket to Accra only to be told that no flight was moving as a result of the ban. These measures, although drastic, counterproductive, and aggressive, ensured that citizens of the three worst-hit nations had no access to their neighbouring countries, including Ghana.

While acknowledging the efforts of Mr. Mahama’s government in insulating Ghanaians against the Ebola virus, it is important to note that Ghana would not have been able to survive the outbreak without a scar. This is because the government’s preparation and efforts were pitifully and patently inadequate. Ghana was saved by Ivory Coast, airline companies, and the other countries that share common borders with the three worst-hit nations.

After January 2016, there had been a total of 11,315 deaths from the Ebola virus with the following breakdown: Liberia (4,809), Sierra Leone (3,955), Guinea (2,536), and Nigeria (8). There was no single case recorded in Ghana and this should not be wholly credited to the efforts of Mr. Mahama.

Kwabena Brakopowers is a journalist, novelist, and essayist whose works focus on politics, migration, social situation, economic and environmental issues. He spends his time writing either in Accra or Monrovia, where he calls his second home.