It was a great joy for the people of Bonthe Island to have MamaYe and its implementing partners – Bonthe District Health Management Team, Messianic Ambassadors For Africa, Health for all Coalition and the Health Education Department of the Ministry of Health and Sanitation – engage local communities in discussion around making their clinics safe for mothers and babies in the current Ebola context.
Target groups included traditional and religious leaders from chiefdom communities (including Paramount Chief/Section Chief/Speaker/Town Chief, Councillors, PHU in-charges, Imams, Pastors, Mammy queens, Teachers, Community Elders) and youths.
This activity took place in six chiefdoms in Bonthe district (Sittia, Dema, Benducha, Norgoba bolum, Kuamebai krim, Imperie) from 19-24 November 2014.
It was amazing to see that these communities are aware of the challenges in their clinics and that they feel they should play a role in fixing the gaps.
Why are pregnant women not attending clinics in Bonthe Island?
- Fear of contracting the Ebola virus from health workers and other patients. There are also rumors that people are being injected or given drugs with Ebola virus
- Unavailability of Free Health Care (FHC) drugs in clinics; pregnant women do not have the resources to pay for the cost recovery drugs. Even during times when FHC drugs are available, the scheme does not cover some other prescribed drugs
- Long distances to clinics; pregnant women are tired of passing a lot of crossing points (rivers) to access clinics
- Attitudes of health workers do not motivate pregnant women to access clinics. Instead, the mode of approach by health workers scares them away
- Presence of drug peddlers in the chiefdoms, selling drugs at the door step of families
Supporting mothers to deliver in safe clinics
Communities already have byelaws stating that any pregnant woman who delivers at home should be fined. For example, in Sittia chiefdom, a fine of Le 50,000 is levied on any pregnant woman who delivers at home and similarly for the traditional birth attendant who delivers a pregnant woman.
However, the communities vocalised the need to ensure that clinics are well equipped and safe. One community authority said:
"MamaYe please also add your voice to ours and when you go back to Freetown, please remind the government to help equip our clinics, our clinics need to be ready to receive and treat patients especially our women and children”.
What have the Island chiefdoms put in place as an Ebola response action?
Communities are conscious that they should step up their actions to prevent Ebola from invading Bonthe Island. This is because Bonthe island chiefdoms have challenging access routes, especially in high tide periods.The following community actions have been agreed to prevent Ebola from invading the island:
Byelaws are set for movement from and to communities:
- “Anybody leaving the village should return the same day, if not we will ask that person to go back to where he/she came from until after 21 days” (A town chief)
- Community youths have organized themselves to be present at check points to help screen passengers entering the district and as well as doing house to house visits in their various communities. In Gbangbama, youths move from house to house taking the temperature of community members and give feedback to the clinic staff
- Chiefs have committed to serve as constant reminders to their communities to report illnesses and deaths immediately
- Communities now have district telephone numbers (076 600440, 076 994496, 078 841899 and 076 983954) which they can use to directly contact the Bonthe Ebola response team. Communities also are aware of using the toll line (117)
In some instances, communities wondered what an Ebola patient looks like or whether there really is a disease called Ebola? This clearly shows that social mobilization activities should be intensified in the island chiefdoms.