Saffie at the Command Center
Renée Zandvliet, Programme Quality Manager, October 2014
Saffie Morovia is a Health Project Officer attached to Concern Sierra Leone’s Freetown WASH project. Freetown WASH is an INGO consortium project aimed at improving water, sanitation and hygiene (WASH) services for vulnerable communities in Freetown. Saffie joined Concern in November 2013.
We meet Saffie on a sunny Tuesday morning in October not at the Concern office or in one of the Freetown WASH project areas, but at the Ebola Operations Command Centre in Cline Town, in the central part of Freetown. The centre is responsible for the coordination of the tracking and referral of reported cases in and around Freetown. When Saffie resumed work with Concern after her annual leave in August, she was asked if she was willing to be seconded to the Command Centre for two months.
Saffie’s promotion (and that of two other Concern colleagues) is part of a four-month DFID-funded Ebola response project, implemented a consortium of the International Rescue Committee (IRC), Concern Worldwide, King’s Health Partners, Marie Stopes Sierra Leone, Save the Children International, Care Sierra Leone, GOAL, Action Contre la Faim and Medicos del Mundo. The consortium is working to support the District Health Management Teams (DHMT) to ensure the alert call centre in each district is functional and responds to all alerts within 24 hours. This is done through secondment of staff to improve coordination and response time, but also purchase of mobile phones, the linking of team members into a closed user group phone network, and the provision of other technological upgrades to improve data flow and efficiency. Saffie now works as a Communications Manager at the Command Centre, five days a week, from 7am to 4pm.
When people call the national Ebola hotline number (117) the call goes to the national call centre, which then relays the information to the district command centres, including the Western Area Urban Command Centre where Saffie works. Saffie explains: “When we receive the information, we alert our Disease Surveillance Officer (DSO) in that area who will then go to the relevant house and investigate the report and complete a form, which is then send back to us. We enter the information in our database and include the details on our white boards so we can start follow-up. We organise pick up of patients so that they can be brought to one of the holding centres and get tested. If they test positive, we continue to follow up and get them to a treatment centre.”
Unfortunately the reality is that there are not enough beds, neither in the holding centres, nor in the treatment facilities, meaning that sick (suspected Ebola) patients referred to isolation remain in the community, waiting until a bed becomes available. Saffie explains that ironically, each Ebola death also means that a bed becomes available to a new patient (potentially) needing treatment. So although the command centre operations do need increased capacity and a massive scale up, it is actually outpacing the rest of case management.
She enjoys the rare days when they are able to refer patients quickly: “I really enjoy it when there is a flow of patients to the holding centres and the treatment centres. And I am happy when we get the alerts; it allows us to help patients get the treatment they need. We have even had a couple of patients who have recovered been discharged.”
“My mom is really worried” admits Saffie, “but the good thing is that it is for two months only so you really stay focused and careful. So whenever my family tells me how worried they are, I remind them that it is only for two months.”
Saffie is supervised by Eunice C. Peacock, the Assistant Command Coordinator. “I oversee all the work, take final decisions on referrals, address problems and ensure the team members have phone credit” she explains. If there is no increase in the number of beds available, Eunice fears that the situation will get worse in the coming months so she is happy with the support from Saffie and her Concern colleagues: “We are all worried but if we all stay at home and do nothing we will never be able to tackle this disease.”
After almost two months at the Command Centre, Saffie is one of the more experienced team members. “When I started work at the command centre, there were just three people and there was a lot of pressure” she says. The team is bigger now — there are about 10 staff — but the number of cases has also increased over the last couple of weeks. Saffie says she is used to the work now and even supporting new colleagues: “Before I go I really want to share with my colleagues all what I know. Sometimes when I have been off for the weekend and I come back on Monday I need to review the work and often spot mistakes. But I don’t blame them; we all have a lot of work and it’s not easy.”
Saffie is very concerned about the rising number of cases in the Western Area and emphasises the need for safe burials and engagement with religious leaders like imams and sheikhs, who she feels have a key role to play. “I have heard so many sad stories of whole families infecting each other and dying of Ebola, even with all the sensitisation. They know they are not supposed to touch and wash dead bodies but when their loved one dies, they forget all that.”
Saffie says she misses her friends at Concern and the weekly staff meetings. “Sometimes I feel like I am missing out on the latest news from the office.” At the same time she is happy she can make a contribution.
With the number of cases increasing every day, isn’t Saffie worried about her own health? “I do worry,” says Saffie, “Of course I do. That’s why I try to take all the necessary precautions. When we enter the Command Centre our temperature is checked and we wash our hands with chlorine water. We regularly use hand sanitiser and we don’t touch each other or shake hands. Since I started working at the Command Centre I even started wearing long sleeves.”
“They know they are not supposed to touch and wash dead bodies but when their loved one dies, they forget all that.”
Although Saffie enjoys her work at the Command Centre and is glad she can make a contribution to the fight against Ebola, she admits she will be relieved when she finished her assignment in two weeks. When asked if she would be willing to go back to the Command Centre for a second assignment at the Command Centre, Saffie laughs: “I don’t know yet. I just want to go rest and go back to my routine first. Let’s see….”
