….Of Forlorn faces and Justice for Ebola survivors from the ECOWAS Court

It was 26 February this year, three days after Nigerians voted in the General Elections in which President Muhammadu Buhari was seeking a mandate for his final term. It was not Sierra Leone’s elections, but for Mohamed Mansaray and members of his Sierra Leone Association of Ebola Survivors (SLAES), their eyes and ears were glued to Nigeria for a different reason.

 The reason? Somewhere in Nigeria’s sprawling capital of Abuja, at the ECOWAS Community Court of Justice , three Judges from Nigeria, Ghana and Ivory Coast  had reconvened to hear a joinder application on whether SLAES should be allowed to join a suit as a fourth applicant in the matter between the Government of Sierra Leone  on one side, and two Ebola health worker survivors and the civil society body, CARL (Centre for Accountability and the Rule of Law) on the other.

The health workers and CARL In December 2017 sued the Government of Sierra Leone, led at the time by Ernest Bai Koroma over alleged mismanagement and disappearance of Ebola funds to the tune of 14 million US Dollars. This, according to the plaintiffs amounts to a violation of their rights to life and health.

Mohamed expected good news. Instead, he received some bad news. The court ruled that SLAES cannot be a plaintiff in the matter. As Secretary General of the over 4,000 certified Ebola survivors organisation, this was a significant setback.  Mohamed was distraught. It was like adding iodine to a wound that shows no signs of healing.

Even before the hearing, the 29 -year-old Mohamed wore a forlorn face.  As a consequence of the Ebola outbreak, his dreams of continuing to practice his cherished job, nursing, paused.  Now, he worries every day about where the next meal would come from for him, about his wife, his three kids and four other orphans who are with him at Maju Drive, Waterloo, on the outskirts of Freetown. Often, on terrible days, he would send the family to bed on ‘gari’ (cassava roots, dried and ground into a flour that needs no cooking to be eaten) hoping that some Good Samaritan might wave a magic wand at him and bring forth a few cups of rice.

 Fending for himself and his family is not Mohamed’s only worry. A survivor of the 2014 Ebola outbreak in Sierra Leone, he joins a list of over 2000 Ebola survivors who complain daily of Ebola health-related problems, such as erectile dysfunction, male infertility, headaches, abnormal menstrual irregularity, joint pain, hearing problem and fatigue.

Before the outbreak, Mohamed had been working as a nurse at the United Council of Imams Hospital at Allen Town in Freetown. His uncle, Alhaji Vandy Lansana Quee, was the doctor in charge of the hospital. Having graduated with a certificate in community health nursing from Pawell Nursing School in that same vicinity, he was fast learning the ropes. Life was good, and his dad was very helpful. He even considered returning to school to further his nursing career.

Then the Ebola outbreak began around May 2014. Fourteen people who had returned from a funeral of a traditional healer, who had attempted to cure others with the virus in neighbouring Guinea, were believed to be the index patients. Mohamed lost ten members of his family including his dad, uncle, brothers and several cousins. He got infected and survived. But he lost all his property. In the three countries combined, close to 12,000 lives were lost or perished, and a total of 28,606 cases of the virus were reported.

Like Mohamed and the thousands of other survivors in the country, expectations of the government were enormous. The previous government promised them thousands of dollars, housing, free medical services and other social and economic amenities.  Some got 250,000 Leones (less than 50 US Dollars), no shelter, and the free medical turned out not to be free at all.

Despite the debilitating conditions of the Ebola survivors, the current government is yet to vigorously pursue a review and a reform of procurement and budgeting policies that will prevent a repeat of such an anomaly in the future.

Survivors still complain about the lack of medical and mental health support, stigmatization, joblessness, lack of job training opportunities and educational support for them. Mohamed says this has made it extremely difficult for them to fully reintegrate into mainstream society. Some of the survivors also cater to the educational, housing and feeding needs of orphaned kids whose parents succumbed to the virus.

It is, however, important to note that the Bio administration in its 2018 Government Transition Report and other interventions committed to investigate and prosecute individuals suspected of stealing the Ebola funds and recover such funds to compensate the victims and survivors. This has yet to happen. Meanwhile, survivors continue to suffer in anguish, and some have died. As at the last count, 65 members of SLAES have died as a result of health complications not unconnected to the Ebola infection. Other survivors across the country may have suffered the same fate, though not recorded.

As an established organisation representing survivors across the country, SLAES is in good standing to articulate the rights and other concerns of the general community of survivors. They can also help in ensuring that a more comprehensive and rights-based approach to providing remedies for the survivors is put in place. However, the three Judges thought otherwise.

Putting the law and the ECOWAS Court aside, it is not only the responsibility of the government to cater for the need of our survivors; it is an obligation. Granted that this was a problem they inherited but they cannot and should not shy away from it.  The remedies the survivors and CARL are calling for are not only for themselves but for all Sierra Leoneans. 

For now, we continue to await the outcome of the ECOWAS Court; but time is of the essence. Survivors continue to live in perpetual hardship. Some of them may have survived the deadly haemorrhagic fever but time and tide wait for no one. They keep struggling with and even dying from complicated health problemsthat are preventable if a pragmatic and speedy approach had been put in place to address their plight.

While it is the Ebola survivors today, the question is: which survivor would survive another onslaught of Ebola or a natural disaster like the mudslide or some huge fire outbreak? There is genuine fear by Mohamed and other survivors that the country has not done much to avoid another Ebola outbreak. This is worrisome!

To save our nation from another catastrophe (I am not talking about one with bullets and guns), we must pay close attention to what is happening to the Ebola case at the ECOWAS Court in Nigeria. Importantly, the current administration should heed to the call for remedies for the survivors and set up a disaster preparedness structure to avert another crisis of alarming and disastrous proportion.  A word for to the wise…

NB: Osman Benk Sankoh, a seasoned journalist and communications expert have worked with the United Nations for over a decade. At the peak of the last Ebola Outbreak in West Africa, he was Head of Community Outreach at the United Nations Mission in Liberia. 

Ebola is over…but are the pains of its survivors?

In the twilight of the first half of 2014, Sierra Leone was hit for the first time by the Ebola virus, unknown to its people and healthcare. Sierra Leone was not the only country assailed by the mysterious virus. Other West African nations of Liberia, Guinea and Nigeria also recorded cases of the virus. There were more than 30,000 recorded cases of infections and a total of about half of those cases succumbed to the virus in the said West African nations. It took Sierra Leone more than a year and half plus loss of about 4,000 of its people to get to zero infection from the inception of the outbreak. Experts and activists opined that very weak health infrastructures combined with its then ailing economy accounted for Sierra Leone’s highest recorded deaths. But it was not only the battered health systems which boosted the spread of the virus, international response to the outbreak also exacerbated the infections and fatalities. The Guardian Newspaper reports [1] that:

Chaotic meetings with local ministers and health officials coupled with a dysfunctional local government and complacency in the west engendered a hellish downward spiral.

The sharpest criticism is levelled at the WHO, which was slow to declare the Ebola outbreak an international emergency, but also failed to heed early alarm calls made by medics who were working in horrific conditions in the Kenema hospital.

The tardy response to the outbreak in Sierra Leone was engendered by the lack of resources, human and artificial, to combat the virus. In 2014, Sierra Leone had fewer than 500 trained medical doctors servicing a population of more than seven million. Its hospitals and clinics were as few and far between as they were grossly under-equipped to respond to any kind of disease outbreak. But in addition to the dearth in its healthcare delivery, donations and aid funds which were pumped in millions of US Dollars were siphoned off by local leadership. The government audit unit uncovered about USD14M which were funds which could not be accounted for during the efforts to beat the virus. Despite the damning audit evidence of suspected misappropriation of direly needed funds, no public official has been prosecuted for the missing Ebola funds to date.  Although there are ongoing commission of inquiry processes which seek to probe into the missing Ebola funds, there is yet to be any findings or recommendations for prosecutions or restitution. 

The emergency measures introduced by the government of Sierra Leone in consultation with international agencies and partners, though unpunctual, substantially helped to stem the rapid spread of the virus. On 7 November 2015, Sierra Leone declared its territory free from the Ebola virus after 42 days of continuous zero infection. The human and social cost of the havoc wreaked on the nation of Sierra Leone might never be quantified as would the unaccounted funds be irrecoverable. By the beat out of the virus, Sierra Leone’s medical personnel which was already in short supply was decimated. A dozen medical doctors, amongst them being, unarguably one of Sierra Leone’s leading medical doctors, Dr. Victor Willoughby lost their saves in a bid to defending their nation attacked by a deadly virus. While there was a cessation of the spread of infection, it was just the beginning of another episode of ordeal for the more than four thousand Sierra Leonean Ebola survivors. The government of Sierra Leone, as usual, pledged nothing shy of adequate facilities and allocation of state resources to Ebola survivors. The pitch of its promise was good, but as the years wore on, survivors’ anticipation of sufficient resources to attend to their post-Ebola health and other social challenges dwindle. 

In January 2018, two unnamed Ebola survivors together with the Centre for Accountability and Rule of Law (CARL), brought an action against the Government of Sierra Leone in the ECOWAS Community Court of Justice. Sierra Leone is a signatory to the Treaty establishing the Economic Community of West African States and its protocol on the establishment of an ECOWAS Community Court of Justice. Amongst the mandate of the court is to hear and determine cases of human right violations by individuals of state parties. The suit prays for a declaration that poor structures within the healthcare sector, delayed response on the part of the government of Sierra Leone to the Ebola outbreak and massive misappropriation of funds/donations by local politicians accounted for the massive infections and deaths. The Plaintiffs, therefore have urged the ECOWAS court to hold that the right to life and health of not only the two Plaintiffs but also of all those survivors who were in similar situations were violated by the Government of Sierra Leone. There are no socio-economic rights guaranteed in the Constitution of Sierra Leone but the state of Sierra Leone is a signatory to a number of leading international human rights instruments which provide and guarantee the right to life, health and wellbeing of the peoples of state parties. Therefore, since a declaration of violation of fundamental social rights might be an uphill task in the municipal courts of Sierra Leone if not impossible to obtain, recourse had to be had to an international court which the state has signed up to, in this case the ECOWAS Community Court.  

The state of Sierra Leone promised its more than 4,000 survivors pyscho-social support and an amelioration of the health systems in Sierra Leone to combat any future outbreak of the Ebola virus or any similar virus. Sadly, more than three years now, the healthcare system is as unprepared as it was, to deal with any medical and humanitarian crisis such as the one ushered in by the Ebola Virus Disease. The health complications of survivors subsist and their hopes based on the commitment of the government of Sierra Leone linger though worn out. It’s been four years since the end of the Ebola Virus in Sierra Leone, but there is no specialized unit for Ebola survivors yet. They continue to battle with and endure myriad health complications and nothing more than the free medical services which previously were only provided to pregnant women, lactating mothers and infants have been extended to Ebola survivors. Survivors’ complaints of sudden loss of vision, infertility, erectile dysfunction, prolonged fatigue, mental issues and undiminished social exclusion and stigmatization continue to rest on deaf ears. With these lingering issues come huge social cost on survivors’ livelihood. Such costs unbearable by their economic distress.   

Sierra Leone has scooped the victory in the battle against the scourge of Ebola brought on its people but is losing the war on its survivors. The enduring agony of survivors remain a constant reminder of the defects in the health care system of Sierra Leone, which have all suddenly re-emerged. The signs of a likely national catastrophe in a magnitude similar or greater than the consequences of the Ebola virus are all too numerous. Unfortunately, the very indifference to the signs, which stoked the spread of the Ebola virus, have returned, like it only took a snappy break. The Ebola outbreak exposed the failings in the health sector of Sierra Leone but may have failed to prick the conscience of the nation to address the systemic failures and transform health institutions in order to combat such outbreaks. Sadly, the status quo ante Ebola has re-emerged and oblivion of the huge social and human costs has set in so suddenly. For survivors, they are left with diminished hopes and heightened health complications. The nation may not be recording any more infections for over three years now, but it is recording huge failures in responding to the plight of Ebola survivors.

About the author:

_Augustine S. Marrah graduated from the Sierra Leone Law School top of class in 2009. The following year he obtained a Masters’ degree in Human Rights Law and democratisation at the University of Pretoria, South Africa where he was also awarded first prize in the annual debate competition at the Faculty of Law._

_Augustine is the immediate past secretary of the General Legal Council —the statutory body that inter alia admits persons to practice law in Sierra Leone—and its disciplinary committee. He is also a Senior Partner at one of Sierra Leone’s emerging leading firms of solicitors—KMK Solicitors. He is co-counsel in the ongoing litigation at the ECOWAS Community Court of Justice against the State of Sierra Leone on behalf of the two survivors and Centre for Accountability and Rule of Law.

WHAT IS THE EBOLA ECOWAS LITIGATION?

In January 2018, two plaintiffs—healthcare workers who were infected with and survived Ebola—and the Centre for Accountability and Rule of Law (CARL-SL) sued the Government of Sierra Leone at the ECOWAS Court of Justice. The plaintiffs allege that the government’s mismanagement of $14M in Ebola response funds caused violations of the rights to life and health of Sierra Leoneans. The plaintiffs rely on the findings of two special audit reports released by the Audit Service of Sierra Leone in 2015 and 2016, which found that the government’s fiscal mismanagement caused “a reduction in the quality of service delivery in the health sector” during the Ebola crisis.

Specifically, the plaintiffs argue that the government’s poor stewardship of the Ebola funds diminished the human and physical infrastructure needed to handle the Ebola crisis including, for example, sufficient numbers of healthcare workers, ambulances, and treatment facilities. The result was a greater number of Ebola infections than would have occurred otherwise. Further, the plaintiffs argue that the government failed to investigate effectively mismanagement of the Ebola funds. Investigation is critical to preventing future violations. 

The plaintiffs seek from the government, among other things:  

·         Review and reform of procurement and budgeting policies, so that funds will not be mismanaged in the future

·         Ongoing medical and mental health support for Ebola survivors

·         Stigma reduction initiatives, employment opportunities, job training, and educational support for Ebola survivors so that they can reintegrate into Sierra Leonean society

·         As recommended in the 2018 Government Transition Team report, a commitment by the government to investigate and prosecute individuals suspected of stealing Ebola funds, and recover said funds to compensate Ebola victims and survivors.

In July 2018, the Sierra Leone Association of Ebola Survivors (SLAES) filed a request with the ECOWAS Court to join the Ebola litigation as a plaintiff. Then, at the end of 2018, the ECOWAS Court set a hearing date of January 24, 2019 to determine whether SLAES should be allowed to join 

On January 23, 2019—just one day before the hearing—the Government of Sierra Leone filed a written objection to SLAES’ request for joinder. The government narrowly argued that because SLAES is not registered with the Corporate Affairs Commission of Sierra Leone, it does not have legal personality and therefore cannot become a plaintiff. The government also claimed that adding SLAES would be “surplusage” that would bring no added value to the case, as SLAES had previously adopted the written submissions of the existing plaintiffs in its joinder request.

In response, SLAES argued that the government had offered an incomplete picture of the legal regime underpinning legal personality in Sierra Leone and that, in any event, SLAES seeks additional relief distinct from that sought by the existing plaintiffs.

The court granted SLAES until Tuesday, February 26 to present its counterarguments in greater detail.

Welcome To The ECOWAS Ebola Accountability Campaign (EAC) Blog!

Welcome to the ECOWAS Ebola Accountability Campaign Blog, the blog and newsroom for the ECOWAS Ebola Accountability Campaign launched by the Centre for Accountability and the Rule of Law (CARL-SL), in consultation with the Sierra Leone Association of Ebola Survivors, and partners. The Ebola Accountability Campaign is a national advocacy campaign that helps build a vibrant civic constituency around the Ebola lawsuit pending before the Economic Community of West African States (ECOWAS) Community Court of Justice.

On this blogsite, we will share information and updates about the ECOWAS Ebola case, our advocacy ideas, news, and releases relating to our campaign. You are more than welcome to respond and add comments and suggestions to our blogs and discussions on this site. We ask that you keep comments relevant to the conversations taking place here so that we can maintain respect for all those involved and add value and depth to the conversation.

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