| A situation like no other – the Ebola crisis in Sierra Leone

Introduction

Late intervention by Sierra Leone’s leadership, a lack of appropriate civic and health education, and the corrupt acquisition of millions of dollars that were intended to combat the deadly Ebola Virus Disease (EVD) in Sierra Leone, have prolonged the life of the EVD in the country. These factors are probably the stimulants behind the continuing spread in Sierra Leone of a disease that started as an epidemic in the French-speaking West African state of Guinea, and has now become a pandemic in the Mano River Basin on which Guinea, Liberia, and Sierra Leone sit and share territorial boundaries. I am living in a country that has been wracked by Ebola for a year now. I have been experiencing a situation unlike anything else I have lived through – the spread of a deadly disease, and a state of emergency that has been in place since August 2014 and allows the police to arrest anyone participating in any public get-together, ranging from a demonstration to a party, and places a stranglehold on the society. Added to this has been the intense worry over the well-being of my family, neighbours and friends, and my concern for the society in general, both now and in the future. Working as a freelance journalist in Freetown, the capital of Sierra Leone, and dealing with this worrisome and intense situation on a daily basis, I have not only been able to experience at firsthand what it is like to live through a pandemic like this, but I have also seen the connections that exist between the unstopped spread of this disease over so many months and the defects in governmental and international institutions. I am sure that even if the Ebola pandemic is “over” at some point, we will then pay the price of the government’s unwillingness to act appropriately and will see an increased rate of poverty and a general breakdown of the country’s economy.

Living with Ebola

As soon as the first confirmed laboratory cases were reported in Freetown, I placed myself in self-imposed quarantine with my family – my daughter and her kids. That was not difficult for me as I work as a freelance communications consultant from home, so – with access to the Internet – I can work from just about anywhere. The decision to go into reclusion meant that we stayed home all day and avoided direct physical contact with neighbours. I even ceased visiting my local bar hangout. What I was compelled to do was to take a ten-minute ride to the market and shopping area once a week to replenish our food supply and get other basic household items. On my return home, and before entering the house, I would take off my shoes, use soap to wash their soles, wash my feet, wash my hands up to the elbows, wash my face, and shake off my dress. It became a routine. But this self-induced seclusion was biting hard: my grandkids would nag at me – or maybe they weren’t nagging; maybe I was just on edge. I would take them out to the courtyard for fresh air. They craved for attention and, before you knew it, I became exhausted. I fell in and out of depression. I had become a prisoner in my own home. The anxiety and uncertainty grew proportionately with the rapidly increasing numbers of confirmed cases in Freetown, and the fear led to despair. I struggled not to allow the panic to engulf me, and all the “what-ifs” went round and round in my mind. What if a member of my family came down with Ebola? I could not afford to send that family member abroad for medical treatment. How could I bear to watch a family member taken away by the Ebola team, knowing it would most probably be the last time I saw that family member? Imagine not to be able to hold and love a sick grandchild! I am the family’s breadwinner. I knew that it was my responsibility to ensure that my family survived this epidemic or pandemic. But first, I had to find a way to feed them. Prices of food and basic commodities were going through the roof. Many stores had been closed to the public, or had cut down on their opening hours. There is no price control mechanism and, because of the state of emergency, which had not yet been suspended, markets were not allowed to open every day. Getting affordable food was proving more difficult each week. It has become almost impossible for many families to obtain their usual one meal a day. The situation is worse than during the civil war, when we were certain that, if we were hit by a bullet or shrapnel, we would be able to get help to take care of the wound. And, if anyone in the community had food, we could all sit together at a communal plate and share it, using our hands. Today, we are not even supposed to touch other people! The mood in Sierra Leone, and in Freetown in particular, is one of uncertainty. There is a lack of clarity at government level and this has led to a sense of distrust among the general population of government officials, the state media, and even health workers.

The lock-down, the state of emergency, and quarantine

Friends and others who have not been in Sierra Leone during this crisis keep asking me how I was able to cope with the “lock-down” [1] of my country in September 2014. However, the lock-down [2] was not permanent; it was a nationwide, three-day period from September 19 to 21. In the campaign that took place during this period, and was referred to as the “House-to-House Ebola Talk”, 7,136 trained teams made up of community volunteers, health workers and NGO partners went house-to-house across the country, raising awareness about the Ebola Virus Disease and soliciting community and family support and participation in the response to Ebola. At least that was the official plan. Like many official responses to Ebola in Sierra Leone, it didn’t quite work out that way. Certainly not every household was visited during the campaign. Mine was not, and neither were those of my immediate neighbours. As we were about to start the nationwide lock-down, vulnerable people in many parts of the country had legitimate questions. How, for instance, would they be able to afford their single meal a day? Many people earn the money to buy the food to make the day’s meal on the day it is cooked. In my neighbourhood, most adults and their children earn their daily bread by using a hammer to break rocks into smaller stones or gravel, which they sell to people who use the stones or gravel for construction. Each day, they try to sell their gravel to earn enough for that day’s food. They have no savings. There is no way to stock extra food even for an extra day, let alone three. Staying home for a three-day lock-down with no work and income looked sure to bring hunger and suffering. My family was fortunate enough to have a small amount of food on hand, so we decided to step in and assist some of the vulnerable people in my community. We were able to provide 17 households, which comprised about 80 adults and children, with their share of rice and fermented and dried cassava (or gari) – two of the country’s staple foods – so that they could prepare meals during the lock-down. This is also an experience to remember: whenever they could, people took care of each other; neighbours and friends took over life-threatening work, and other work they were never paid for. From time to time, some districts and chiefdoms imposed longer periods of lock-down, as happened in the Tonkolili district in the north from November 29 to December 15. The most recent one was in the diamond-rich district of Kono [3] – from December 10 for a period of two weeks. A World Health Organisation investigation revealed that 87 bodies had been buried over 11 days in the Kono district. This signalled an alarming rise of the EVD in the district, which still had only one ambulance to transport the sick, and blood samples for testing [4]. I continue to explain to friends, and others curious about how we coped, that the state of public emergency was instituted at the end of July for about three months, but still stands. Under this status, freedom of association, congregation, and movement are restricted. Freedom of expression is also threatened. A journalist recently paid the penalty after expressing himself in a radio programme on matters related to Ebola, talking about the manner in which the EVD has been handled and the games that are at play. He suggested that the aftermath of these “games” could produce a look-alike of the recent uprising in Côte d’Ivoire. Quarantine status is declared in the event that there is a suspected or laboratory-confirmed case of Ebola. The house, its inmates, and their courtyard are quarantined and are placed under security and health surveillance for 21 days. Those quarantined are only released when none of them shows signs or symptoms of Ebola after the 21-day period. In such circumstances, it is as if life has been placed on hold and people have to wait for a go-ahead signal, a green light that will restore normal life again. Although nothing feels normal these days in Sierra Leone.

Only fanning the flames at the start of the crisis

When reports of confirmed Ebola cases surfaced on May 25, 2014 [5] in Kailahun, a district in the east of the country near the border with Guinea and Liberia, the initial response seemed to consider it an occurrence very far away from Freetown. This was the same reaction as the one that occurred in the capital city when the first conflicts in what was to become Sierra Leone’s bloody civil war broke out in Kailahun in March 1991. But, unlike in the civil war that spanned more than ten years and killed 50,000 people, there is no respite at all from Ebola. The disease rages like wildfire. It does not spend time laying ambushes. It does not make efforts to hide from the “enemy”. And it does not take time off to reload guns and refill tanks. After the first cases, Ebola raged on beyond the borders of Kailahun to the Kenema district, 51 miles (82 kilometres) away. Eventually – like in the civil war, but at a much faster pace – it bulldozed its way from the east to Freetown, 186 miles (about 300 kilometres) away. In just three months, from October to early December, the number of new Ebola cases in the country’s Western Area, including Freetown and its environs, surpassed the number in any of the country’s other 12 districts. World Health Organisation figures, released in early December 2014, put the cumulative number of cases since the start of the outbreak in March 2014 at 7,780 in Sierra Leone and 7,719 in Liberia. In Guinea, the figure was 2,283 [6]. The fact that Sierra Leone has had more than three times as many cases as Guinea, the country where the initial outbreak of the Ebola Virus Disease occurred in December 2013, is a matter of grave concern to Sierra Leoneans. [7]

A lack of leadership

In early 2014, as news spread in the east of Sierra Leone about the outbreak across the border in Guinea, most citizens and civil society organisations demanded that the border with Guinea be closed as a step towards preventing and containing the spread of the virus. It was only on June 11, 2014, that Sierra Leone shut its borders for trade with Guinea and Liberia in an attempt to slow the spread of Ebola. Based on the socio-political setting in this West African country, citizens always look up to the president, hoping that he will take the lead, console them, give them strength, and promise that “it will be done”. None of this happened until three months into the epidemic in Sierra Leone, when, on July 1, 2014, President Ernest Bai Koroma finally broke his silence and addressed the nation on Ebola. [8] In his public address, the president announced some initial measures to combat Ebola and enthusiastically acknowledged the efforts and sacrifices of health workers in the first two provinces ravaged by the virus. “I hereby instruct the immediate absorption of these brave volunteer nurses and health workers in Kailahun and Kenema into the civil service,” he said. In his second address to the nation at the end of July, the president proclaimed a state of public emergency as a measure to handle the Ebola outbreak. [9] That is when public congregation was banned – as it still is. The address came a day after Dr Sheik Umar Khan, a leading Sierra Leonean doctor and a specialist in viral haemorrhagic fever, died of Ebola. He was the first of a dozen doctors to be infected, ten of whom died between then and early December. The instructions in the president’s address gave way to a series of restrictions, including the closing down of private and public schools and other institutions of formal education. A limit was also placed on the working hours of commercial motorbike riders, some of whom were reportedly carting away people suspected of being infected with Ebola, and the dead. However, markets where thousands of people brush against one another, and religious places like churches and mosques where hundreds congregate, were exempted from the ban. The president also declared August 4, 2014, to be a National Stay at Home Day for Family Reflection, Education, and Prayers on the Ebola outbreak. The continued state of emergency and ban on public congregation have resulted in significant socio-economic problems that are affecting many elements of the country’s short- and long-term development agenda. Let us take, for instance, the closing of educational institutions; this has reportedly led to an increase in teenage pregnancy and rape. [10] Sierra Leone is a country where, for cultural, traditional and economic reasons, it was already difficult to keep girls in school. Teenage pregnancy was already high in certain regions of the country, and rape was already a concern. Human rights activists and the civil society movement worked together with the government of Sierra Leone over a very long period of time to address these issues and this collaboration culminated in the enactment of the three gender Bills in June, 2007. But now, many months into the Ebola crisis in the country, 13- and 14-year-old girls are becoming pregnant and even being forced into early marriage. [11] All this is undoing the significant headway that was being made, and the significant gains that were beginning to become visible, with more girls in school and parents relieved of paying huge school charges, which are now supplemented by the government.

Communication and public education

When it was desperately needed at the start of the outbreak, there was no appropriate and clear communication from the government to the population. Instead, Sierra Leoneans mostly relied on social media for information and news about Ebola. And it was to these same media that the citizenry turned to find cohesion in the face of the looming disaster. At a press briefing in May 2014, the then Minister of Health and Sanitation, Miatta Kargbo, told the public that Ebola patients were responsible for their own deaths because they had not adhered to the government’s warning not to visit neighbouring Guinea. She went even further the following month when, in a parliamentary hearing, she said that two nurses who died from Ebola had contracted the disease when engaging in extra-marital sexual relations. The government’s preliminary information about Ebola symptoms and the chances of survival was unhelpful at best and often blurred and may have contributed to the initial despondency and fear felt by most people. Because there was no robust test for the disease in the early phases of the outbreak, people in affected areas such as Kailahun and Kenema turned to their town or village dispenser or nurse when they felt ill, and some wound up being treated for malaria, the early symptoms of which resemble those of Ebola. It was at this time, early on in the epidemic, before it had taken hold in large cities such as Freetown, that Sierra Leoneans should have been educated about Ebola so that they would know when they needed to visit a health centre. There were also times when people were unclear whether or not they could trust the information coming from the government. For example, when the outbreak began, the Ministry of Health and Sanitation said there was “no cure” for Ebola. Weeks went by before the information metamorphosed into “no known cure”. It was, therefore, not unusual for people to hide and nurse their sick at home. The feeling was that, if there was “no cure” in the health centres, there was no point in people going there. Citizens were not initially informed that there is a chance of surviving Ebola and today many people are questioning what it was that the official Ebola survivors were suffering from in the first place. As I write, the rainy season in Sierra Leone is just ending. This is a time of year that brings many water-related diseases, including diarrhoeal disease, which is especially common among slum and bay area residents who lack access to good sanitation. Malaria and typhoid are also prevalent and each of these carries its own significant death toll. According to the World Malaria Report 2014 [12], there has been a rise in malaria in recent years, but there has been no real public information about its prevalence throughout this year’s rains. Many people are wondering why they were not hearing about deaths caused by malaria and typhoid this year. Data provided by Medico International shows that, in the first four months of the Ebola epidemic, meningitis and tuberculosis were more deadly than the EVD, as were some other diseases. While about 440 people died from Ebola, more than 3,000 were killed by malaria, nearly 900 by diarrheal illnesses, and nearly 800 by HIV/AIDS [13]. If accurate statistics about the prevalence of any of the above diseases had been regularly made available to the public, this could have been a step towards breaking the cycle of fear and creating trust. When citizens have the opportunity to access information from the Centers for Disease Control in the United States and learn that there are two to three times more cases of Ebola in Liberia, Sierra Leone, and Guinea than are being officially reported in those countries, the mistrust of information from their own government deepens.

Dollars pour in

Sierra Leone should have used the proceeds from its vast and varied natural and mineral resources to commence the fight against Ebola instead of waiting for the international community to render aid. It is a country rich in aluminium, bauxite, diamonds, gold, iron ore, titanium dioxide (rutile), limonite and zircon, to name but a few of its resources [14]. In the diamond industry alone, more than 400,000 carats were produced in 2010, making Sierra Leone the world’s tenth largest producer of diamonds, and accounting for nearly half of the country’s total exports. However, the country reneges on publishing the contracts it has with extractive companies and releases only fractional data on important aspects of the mining industry [15]. In addition to the revenue, much of it undisclosed, from the mining sector, the country has leased hundreds of thousands of hectares of land to large-scale foreign investors interested in the production of biofuel and crude palm oil. The terms of some of the land leases that I have seen would be laughable were they not so unfair to the local people whose farmland is lost. [16] To garner home-grown cash to combat Ebola, a special bank account was established to raise money to fight the disease [17] – and the stream of “philanthropists” continues to grow. The corporate world has also contributed to providing the needed cash. (See the short list I compiled. [18]) Notwithstanding the overwhelming inpouring of support and cash, doctors, nurses, healthcare workers, and members of the Ebola burial teams have all gone on strike at different times in different parts of the country over the risks they undertake in treating Ebola cases, the non-payment of allowances or salaries, and the lack of tools they need to execute their job [19]. In the meantime, there has also been generous financial support from the international community in cash and in kind. This includes £230 million pumped in by the United Kingdom’s Department for International Development. At the start of December, the physical response by the international community was beginning to be seen on the ground. Treatment centres in various parts of the country, including Freetown, were built and equipped. From the hilltop where I have my home, I see the centre in Goderich on the road leading to the Milton Margai College of Education and Technology. It is now run by the Italian organisation, Emergency. About two neighbourhoods away, Kerry Town, near the famous Lakka Beach, hosts another centre with 92 beds. Because of the shortage of staff, and incoherent coordination, only about a third of them have been used. It was not far-fetched that the president, in his address to parliament on December 5, 2014, stressed the dire need for personnel for the treatment centres, saying that “without them, treatment centres are non-operational”. He added: “We are acting on getting more personnel to the country, and more support in training for health workers.” He also stated that his government had developed a post-Ebola recovery plan. “This may be modified as we move along, but we will stop this outbreak and recover from it unto greater strength.” Such lofty words come even as there are outcries from the people, who complain that, while medical workers’ needs are not adequately being met, parliamentarians and Paramount Chiefs have received millions of dollars from the government to enable them to undertake Ebola-related actions in their constituencies. The outcries forced parliamentarians to summon the Sierra Leonean Association of Journalists in September. The leading journalists’ union in the country was told in no uncertain terms that journalists must back off from asking questions regarding the 63 million Leones (about $14,000) [20]/[21] given to each Member of Parliament to conduct Ebola-related activity in his or her constituency. Three months later, in the first week of December, Paramount Chiefs across the country received a total of $1.2 million [22] for the same purpose in their respective chiefdoms. As the second week in December approached its end, it was discovered that an Autopheresis plasma machine had apparently disappeared without trace. According to some experts, the machine can produce serum for more than 10,000 people and could halve Ebola deaths in Sierra Leone. A vigorous social media campaign, in which I participated, was launched by BBC journalist Umaru Fofanah and, within hours, the machine was produced. Officials in the health ministry and the Central Medical Stores had earlier denied knowledge of its whereabouts.

Conclusion

The crisis in handling the current situation did not start with the advent of the Ebola Virus Disease. The scene was already set with a weak healthcare system in which one medical doctor attends to 30,000 inhabitants. Today, because ten doctors have now lost their lives to Ebola, the situation is even worse: 300,000 thousand inhabitants will now have to search for a new doctor. My hope is that the Ebola recovery plan drawn up by the government of Sierra Leone will serve the legitimate beneficiaries: those orphaned because of the death of their parents from Ebola [23], Ebola survivors, and those caring for Ebola orphans and survivors. The government should be pressured into making a long-term commitment to funding and monitoring the welfare of Ebola orphans and survivors, and should protect them from discrimination and stigmatisation. However, there needs to be political will to address the problems caused by the loss of an academic year, and the consequences for the future of the education of girls must be given prominence in the Ebola recovery plan so that the cycle of poverty can be eliminated. To ensure that the Recovery Plan works, the government has to operate with integrity and transparency. Sufficient education and finance must be made available to sustain the scheme. Eighty percent of the citizens of Sierra Leone have no healthcare coverage [24]. The government needs to provide affordable education, healthcare, and social welfare services that are beneficial to the people – not the vices of corruption [25].

Notes

[1] President Ernest Bai Koroma, President Koroma’s Address to the Nation on the Three-Day Stay at Home Ose to Ose Ebola Tok Campaign, ernestkoroma.sl/president-koromas-address-to-the-nation-on-the-three-day-stay-at-home-ose-to-ose-ebola-tok-campaign/ (accessed December 10, 2014). [2] Youtube, President Koroma delivers 3 day lockdown speech, 20.09.2014. www.youtube.com/watch?v=rN3zTo8gfSI (accessed December 3, 2014). [3] BBC, Ebola crisis: Sierra Leone bodies found piled up in Kono, December 11, 2014. www.bbc.com/news/world-africa-30429360 (accessed December 11, 2014). [4] Umaru Fofanah, UPDATE 1-Sierra Leone locks down new Ebola hotspot in the east, Reuters, December 11, 2014. www.reuters.com/article/2014/12/11/health-ebola-leone-idUSL6N0TV44E20141211 (accessed December 10, 2014). [5] World Health Organisation, Fighting the Ebola outbreak in Sierra Leone, WHO, July 2014. www.who.int/features/2014/ebola-sierra-leone/en/ (accessed December 9). [6] World Health Organisation, Ebola Data and statistics – Situation summary Data published on 08 December 2014, WHO, December 8, 2014. apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-latest?lang=en (accessed December 8, 2014). [7] Note by the editor: And, the decline in numbers reported in the last weeks seems to be least in Sierra Leone, as the WHO declares in January of 2015 – alttogether in January of 2015 there were 22.057 reported cases in Westafrica (of whom 9.000 people died), from which Sierra Leone accounts for 10.400 cases. [8] President Ernest Bai Koroma, President Koroma’s Address to the Nation on the Ebola Disease 1st July 2014.  ernestkoroma.sl/president-koromas-address-to-the-nation-on-the-ebola-d isease-1st-july-2014/ (accessed December 5, 2014). [9] President Ernest Bai Koroma, President Koroma’s Second Address to the Nation on the Ebola Outbreak July 30, 2014. ernestkoroma.sl/president-koromas-second-address-to-the-nation-on-the-ebola-outbreak-july-30-2014/ (accessed December 5, 2014). [10] Plan International, Teenage pregnancy rates rise in Ebola-stricken West Africa, 17 November 2014. plan-international.org/about-plan/resources/news/teenage-pregnancy-rates-rise-in-ebola-stricken-west-africa/ (accessed December 10, 2014). [11] Bampia James Bundu, Teenage pregnancy concerns girls in Sierra Leone, in Politico, December 9, 2014. politicosl.com/2014/12/teenage-pregnancy-concerns-girls-in-sierra-leone/ (accessed December 9, 2014). [12] World Health Organisation, World Malaria Report 2014, WHO, www.who.int/malaria/publications/country-profiles/profile_sle_en.pdf?ua=1 (accessed December 8, 2014). [13] www.medico.de/en/themes/health/documents/global-responsibility/1289/ [14] Note by the editor: see also the report on Sierra Leone’s massive revenue  losses from tax incentives by the Tax Justice Network Africa and partner organizations, www.taxjusticeafrica.net/ or at legacy.zeitschrift-luxemburg.de [15] Medico International, Global responsibility – A global health fund could have prevented the spread of Ebola in West Africa, December 4, 2014. www.resourcegovernance.org/countries/africa/sierra-leone/overview (accessed december 10, 2014). [16] Oakland Institute, Understanding land investment deals in Africa. Land Deal Brief: SOCFIN Land Investment in Sierra Leone. Socfin Agricultural Company Sierra Leone government sublease, April 2012. www.oaklandinstitute.org/sites/oaklandinstitute.org/files/Socfin_Agricultural_Company_Sierra_Leone_gov_sublease.pdf (accessed July 12, 2013). [17] State House Communications Unit, More donations received to fight Ebola, September 9, 2014. www.statehouse.gov.sl/index.php/the-president/977-more-donations-received-to-fight-ebola- [18] Corporate Citizenship Center, Ebola Outbreak — Corporate Aid Tracker, (last update December 5, 2014). www.uschamberfoundation.org/ebola-outbreak-corporate-aid-tracker (Self-compiled/relevant) short list accessed December 5, 2014). A) To the Government Sierra Leone from: 1. Ecobank – $50,000; 2. Mercury International (one of the largest sports betting and lottery companies in Sierra Leone) – $56,880 and SocFin Agricultural Company – $13,600. B) To healthcare workers caring for Ebola patients in Sierra Leone from: 1. Citi Bank – one million protective masks. C) To Country Representative of UNICEF in Sierra Leone from: 1. London based construction company, Dawnus International – $25,000. D) To the local district councils in Sierra Leone from: 1. Sierra Rutile – $22,750. E. To the Ministry of Health and Sanitization from: 1.The Association of Sierra Leone Commercial Banks – $34,250. [19] Lisa O’Carroll, Ebola crisis: Sierra Leone doctors go on strike over inadequate equipment. The Guardian, December 9, 2014.  www.theguardian.com/world/2014/dec/09/ebola-crisis-sierra-leone-doctors-strike-inadequate-equipment (accessed December 9, 2014). [20] Awoko, MPs angry over media spotlight, September 17, 2014. awoko.org/2014/09/17/sierra-leone-news-mps-angry-over-media-spotlight/ (accessed December 9, 2014). (Note: Page says “error” on December 14, 2014). [21] Kemo Cham, Sierra Leone MPs threaten to gag media over coverage of Ebola funds use, Daily Nation, September 17, 2014. mobile.nation.co.ke/news/Sierra-Leone-MPs-media-Ebola-funds/-/1950946/2455156/-/format/xhtml/-/2ejk0r/-/index.html (accessed December 4, 2014). [22] Awoko, NERC gives $1.2 million to paramount chiefs, awoko.org/2014/12/04/sierra-leone-newsnerc-give-1-2m-to-paramount-chiefs/ (accessed December 9, 2014). (Note: Page says “error” on December 14, 2014). [23] Umaru Fofanah, Umaru Fofanah reports from Sierra Leone’s Ebola orphanages, November 13, 2014. soundcloud.com/bbcafrica/umaru-fofana-reports-from-sierra-leones-ebola-orphanages (December 3, 2014). [24] International Labour Organisation, Global health protection crisis leaves almost 40% of the world’s population without any coverage. New ILO study reveals large health coverage gaps, including in West African countries, where 80 per cent have no coverage, December 12, 2014.  www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_326227/lang–en/index.htm?utm_content=buffer42a16&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer (accessed December 12, 2014). [25] Anti Corruption Commission of Sierra Leone, ACC intercepts 4250kgs of rice supply meant for Ebola quarantined homes, October 2, 2014. www.anticorruption.gov.sl/show_news.php?id=406 (accessed December 5, 2014); Anti Corruption Commission of Sierra Leone, ACC intelligence leads to police arrest of cholorine fraudsters, November 21, 2014. www.anticorruption.gov.sl/show_news.php?id=433 (accessed December 2014); Awareness Times, Cabinet Minister in Italy ‘Ebola Rice’ Scam as Presidency Looked Askance Upon, December 10, 2014. news.sl/drwebsite/publish/article_200526849.shtml (accessed December 11, 2014); Awareness Times, Criticisms for President & ACC over Italian ‘Ebola Rice’ saga, December 12, 2014. news.sl/drwebsite/publish/article_200526867.shtml (accessed December 13, 2014); Jeffrey Gettleman, As Ebola Rages, Poor Planning Thwarts Efforts, New York Times, December 6, 2014. www.nytimes.com/2014/12/07/world/africa/as-ebola-rages-in-sierra-leone-poor-planning-thwarts-efforts.html?_r=0 (accessed December 10, 2014); Alpha Barrie, ACC to Investigate 6000 Medical Ghost Workers, Premier Media Group Limited, November 28, 2014. premiermedia.sl/content/acc-investigate-6000-medical-ghost-workers (accessed December 6, 2014).