Monday, December 1, 2014
Changing behaviour to tackle Ebola
Why is the number of Ebola infections continuing to increase in Sierra Leone? Andrew Harding found four "stark" reasons at a village near Freetown
Africa correspondent BBC
For weeks it has been the same here in Sierra Leone's capital, Freetown. Every day the Ebola burial teams - now well organised and promptly dispatched - collect about 60 bodies from around the city and its crowded suburbs.
Some days it is 50, sometimes as many as 80.
About 20% of those bodies turn out to be Ebola cases. The rest are just the usual range of deaths you might expect in a large city in West Africa. Every death is now treated as suspicious.
There is an air of brisk efficiency at the workers' base - the British Council offices, on a hill overlooking the Atlantic Ocean, now transformed into an Ebola command centre for the western region of Sierra Leone.
Calls are logged, white boards filled, statistics for the past month collated by close-knit teams.
Down the hill, at the municipal cemetery, bulldozers are busy clearing new ground, scraping away mounds of rubbish to give the gravediggers more space.
"At the moment we're having some success in holding on to the epidemic and I don't see the more astronomical predictions coming through at the moment," said British army Colonel Andy Garrow.
Dying at home
And yet, as the weeks go by and the body collection teams continue to bring in the same number of corpses, Col Garrow finds himself drawn increasingly to one particular conclusion.
"Behaviour change," he says. Or rather the lack of it.
Sometimes suspected Ebola cases are not reported to the health authorities
Here is the problem: By now, everyone knows about Ebola; and nobody with symptoms should, logically, be dying at home or on the street anymore.
They should all have been taken to hospital.
But to understand why that is not happening, all you have to do is drive to any of the impoverished suburbs of Freetown.
Mariatu Kamara had been hiding her illness for several days.
When we found her outside her home in Rogbangba village only a few people knew she was sick - a headache, sore bones and boils on her head and legs.
Perhaps it was not Ebola. But if it was, her three young children - one tied to her back - were at grave risk.
Ebola burials
• Bodies still contain high levels of the Ebola virus
• At least 20% of new infections occur during burials, WHO says
• Relatives perform religious rites including touching or washing the body
• Safe burial process involves observing rituals differently, such as "dry ablution"
• Volunteers with full protective clothing are trained to handle and disinfect bodies
"I don't have a phone," Ms Kamara explained at first, when I asked her why she had not contacted the Ebola telephone hotline.
But she became visibly alarmed when I suggested we could help.
"I can't leave my children here on their own," she said. Her nine-year-old daughter, Aisatu, began to cry.
The village headman, Abdul Karama, arrived and promptly called 117 to report a possible Ebola case.
He was worried that it would not make a difference. "We call, but sometimes nobody comes," he said, citing other instances.
Ignoring quarantine
A few doors away, Rogbangba village revealed another problem - quarantine.
Fifteen-year-old Aminata Bangura died last week of suspected Ebola.
The rest of her family - 11 people - were promptly told to stay indoors. Food parcels were delivered to help them out.
But it was quickly obvious that the family were ignoring the quarantine order.
We saw Ms Bangura's brothers emerging from a crowded mosque across the dirt road.
"It's lonely at home. I go to the mosque because I don't know how to pray on my own," said 22-year-old Ibrahim Bangura.
He continues to run a hairdressing business from a nearby wooden shack.
The local headmaster - now out of work because the schools are closed - has become a fervent anti-Ebola campaigner and social mobiliser.
But Godfrey Kamara is finding it almost impossible to change the community's behaviour.
"It's not working. When they're quarantined people should stay around and have security. And they still wash the dead," said Mr Kamara, accusing Ms Bangura's family of doing just that.
"They washed her body before calling 117. I know it. They shouldn't do that. I tell everyone they shouldn't wash the body but they still don't believe Ebola kills.
"I've been house to house telling them not to touch bodies, but they still do it," he said in a quiet fury as he stood on the road outside the quarantined house.
Later, I called Mr Kamara to find out what happened to Mariatu Kamara (no relation).
She had been taken the next day to a hospital in Freetown. Her children were being looked after by neighbours.
But while he was on the phone, Mr Kamara said those neighbours were now attacking him - blaming him for breaking up the family.
"They're angry with me," he said, before hanging up.
Women's fightback video goes viral TV grab of the incident The incident was captured by a passenger on a mobile phone
A video of two sisters beating up three men, who were allegedly sexually harassing them on a moving bus in India, has gone viral on social media.
The men have been arrested and charged with assault, police said.
Friday's incident, recorded by a passenger on a mobile phone, took place in the northern state of Haryana.
Violence against Indian women has been in the spotlight since the gang rape and murder of a student on a bus in the capital, Delhi, in December 2012.
The attack caused outrage and prompted India to introduce stringent anti-rape laws.
The latest incident happened in Rohtak district when the two students, 22-year-old Aarti and 19-year-old Pooja, were on their way home.
Younger sister Pooja told BBC Hindi that the three young men "threatened us and abused us".
"The men started to abuse me and touch me. I told them 'if you touch me again, you'll get beaten up'. They called a friend on the phone and told him to 'come over because we have to beat up some girls'," Pooja said.
She said they decided to take on the attackers when other passengers did not come to their help.
"No one came forward in the bus to help us. So we took out our belts in self-defence [and hit the men]. If only the other passengers had helped us, we would not have needed to retaliate in this way," she said.
However, the video of the incident shows at least one male passenger repeatedly trying to separate one of the men from the women.
The sisters said the men pushed them out of the bus when it came to a halt after some distance and attacked them again.
They said they retaliated by throwing a brick at the men who then fled.
Police say they received a call from the women on Friday afternoon, and the three men were arrested on Sunday evening.
Senior police official S Anand told The Hindu newspaper that they were contemplating action against the bus driver and his helper.
"The driver was supposed to take the bus to the nearest police station. But he did not do so. The conductor also did not intervene. We are considering legal action against them," he said.
Correspondents say public abuse of women - called "Eve teasing" in India - is rampant in parts of the country.
"Eve teasing" often makes life miserable and even dangerous for women when they go out in public.
Meanwhile, the sisters have received much support on social media and many have been tweeting to praise the #RohtakBravehearts.
Deepti Kaul hoped others would follow the sisters' example:
Shweta Shalini tweeted that "girls have now learnt to fight":
Vinay Sahasrabuddhe said male mindsets had to change:
Congress Party MP Naveen Jindal said it was "shameful" that no-one on the bus came forward to help the women:
The general’s pledge
Tariq Khosa
Hard talk is one thing but tall claims should be made carefully. “Daish will not be allowed in Pakistan and Afghanistan,” said our army chief during a week of military diplomacy in the US recently.
Music to American ears? Can the chief prevent diehard Taliban and their surrogates in Af-Pak from heading to the Middle East’s combustible inferno to join the warriors of the so-called Islamic State? We can remove IS wall chalking but bigots on a suicide mission are difficult, though not impossible, to deter.
The general said that the military operation in progress was “against all hues and colours, and it is without any exception, whether it is Haqqani Network or Tehreek-i-Taliban Pakistan or anything”.
Read| Those who butchered soldiers will not be spared: Raheel
His pledge to continue the war against extremists until all terrorist groups were eliminated will be tested in his ability to de-link elements within the security agencies from the militant non-state actors and religious hardliners working for far too long as proxies in regional turf battles.
Another statement by the army chief, that Operation Zarb-i-Azb was not just a military offensive but “a concept to defeat terrorism in all its forms and manifestations”, defies ground reality, for this cliché does not address the confusion that prevails in society over how to tackle the militant mindset.
Forces of destructive religious extremism were unleashed due to faulty state policies, and the sponsors of violence and intolerance still find themselves perched on the fulcrum of internal conflict.
Instead of denials and blame games, we should set our house in order.
Frenzied fanaticism was yet again on display in Lahore’s suburbs recently when a mob, instigated by allegations of blasphemy against a poor and illiterate Christian couple, burnt them to ashes in the furnace of an avaricious brick-kiln owner. Can a military offensive defeat this mindset? General, think before you speak.
Last month’s military diplomacy coincided with the sixth anniversary of the Mumbai terror attacks. Also, the prime minister has just concluded an important diplomatic mission to Nepal for the Saarc summit against the backdrop of aggressive Indian designs to tarnish our image and alienate us on account of terror networks to sidetrack the real dispute over Kashmir.
“India’s propaganda that Pakistan shields terrorists is in fact an attempt to hide its own sins. We are curbing terrorism and terrorists,” said the prime minister a few weeks ago, adding that “blaming Pakistani institutions for acts of terrorism is a pack of lies.”
However, instead of denials and blame games, we should set our house in order.
The trial — in a speedy trial anti-terrorism court in Adiala jail — of the seven LeT operatives arrested for their role in the November 2008 Mumbai attacks is progressing at a snail’s pace.
Although the FIA’s Special Investigation Group did a very professional job of collecting evidence for the culprits’ indictment, the trial process slowed down following the FIA prosecutor’s murder and some material witnesses resiling from the original testimony: this may result in considerable national embarrassment if the ends of justice are not met soon.
The ‘concept’ of defeating terrorism in all its manifestations must start with addressing our basic internal security fault lines. Tackling sectarian terrorism should be our foremost priority.
Hardly a day passes when Lashkar-e-Jhangvi (LJ) militants do not target Shias in the country. Jhang was the epicentre of sectarian hatred in the early 1980s when firebrand cleric Haq Nawaz Jhangvi’s vitriolic anti-Barelvi tirades suddenly turned anti-Shia during the Zia era.
He, along with three others, founded the Anjuman-i-Sipah-i-Sahaba in 1985, later renaming it Sipah-i-Sahaba Pakistan.
After his murder in 1990, Riaz Basra, Malik Ishaq, Akram Lahori and Ghulam Rasul established a militant wing of the now banned SSP (which has re-emerged as the Ahle Sunnat Wal Jamaat) and named it after him as Lashkar-i-Jhangvi.
Riaz Basra was arrested in 1992 by Lahore police but escaped from a judicial lock-up in 1994 and went on a spree of ‘holy’ killings till his capture and death in 2002. Meanwhile, Ghulam Rasul was also accounted for by the Punjab police.
The remaining two out of the original gang of four are still reportedly masterminding sectarian attacks from behind prison walls or detention centres.
The Shia Hazara community in Balochistan has also become a victim of savage attacks, especially since the escape of two hard-core LJ militants Saifullah Kurd and Dawood Badini from a high-security detention facility in Quetta cantonment in early 2008.
Finally, one of the aforementioned fugitives has recently been apprehended and this may prove to be an important breakthrough.
The TTP remains responsible for most violence in the country. It claims to have carried out “778 attacks since 2000”, according to a recent report released in London that ranked Pakistan third on the Global Terrorism Index.
The year 2013 was the most violent, with 2,345 lives lost in 1,933 incidents, and the decision to launch the military operation in North Waziristan Agency in June this year was belated but necessary. Its results so far are being acclaimed as more than satisfactory but the battle is far from over.
The military operation in Fata against TTP and its affiliates should bring in its wake rehabilitation of IDPs, economic opportunities and a criminal justice framework. Effective border control measures and proper administrative systems need to be established.
In Balochistan, the writ of the state should be enforced through the rule of law by expanding the jurisdiction of police so that the Frontier Corps can concentrate on border control. Similarly, the Karachi operation should focus on eliminating crime rather than the criminals. Violence begets violence and brutalises society.
This is a dangerous trend and yet another destructive extreme.
In the absence of a national security policy, a counterterrorism strategy or a counter-extremism plan, the military is trying to do what it is trained to do: shoot to kill those that it considers to be enemies of the state.
Unfortunately, the battle for hearts and minds cannot be fought or won through guns alone.
It is socio-economic justice, rule of law and due process that will eventually make a difference.
The writer is a retired police officer.
Courtesy: Dawn
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