The people versus the pandemic: community organisations in the fight against Covid-19 in Freetown
This brief is by Emmanuel Osuteye, Braima Koroma, Joseph Macarthy, Sulaiman Kamara and Abu Conteh. It was published by Knowledge in Action for Urban Equity (KNOW) on 30 April 2020.
In Sierra Leone, the mention of the ongoing coronavirus pandemic immediately evokes very grim memories of its recent brutal battle with Ebola in 2014-15. Like the two other countries that became the epicentres of the epidemic in West Africa, namely Liberia and Guinea, the healthcare system had suffered years of underinvestment and did not cope well. There were not enough surveillance systems, response capabilities, public health infrastructure, or diagnostic capabilities in place. A lot has changed since then, and it is clear that the country learnt valuable lessons from the Ebola experience. Notably, improvements have been made in surveillance systems and reporting mechanisms, and the National Disaster Management Department has been empowered to operationalise emergency response systems. The government launched a National COVID-19 Preparedness Plan, which focused primarily on strengthening surveillance at the three official points of entry and deployed it even before the country recorded its first case on 31st March 2020. Arguably, these measures played a precautionary role; they helped in the delay of the onset of the pandemic and bought vital time for other, centralised government responses. However, the scale of infrastructural improvements since Ebola, gaps in technical capacity, as well as ongoing challenges of affordability and accessibility, particularly for the urban poor, leave healthcare in Freetown and Sierra Leone still in a very fragile state.