|Ernest Garnark Smith, Jr|
It’s often said that the mindset of an individual, people and, even a nation significantly determines the rate and pace at which they tend to perform given tasks and even prevail against any foes. Without doubt, it’s glaring that Mama Liberia is fiercely at war against a determined foe called EBOLA. And, if the truth is being told and the stats are being analyzed and concerned raised at all level, we are regrettably on the verge of nearest to losing the uphill battle against our foe Ebola because some cardinal components are being labeled, seen and treated as non-essentials. Paramount amongst the ‘non-essentials’ is the lack of the provision of quality psycho-social supports to three distinct and crucial parties in the very fight: the victims (confirmed Ebola victims and suspected Ebola victims ) ; the families of confirmed victims, suspected victims and, health workers who died while providing cares for victims; and health workers and care-givers.
In every epidemic and disaster management situations I have even read of, witnessed and provided services, I have always vividly seen quality psycho-social supports being given priority, credence, well-funded and allowed to be provided without unnecessary hindrances. Sadly, reverse is the case in our national fight against Ebola despite the allocation of funding from tax payers money for the provision of the said vital service.
Every Ebola victim is a human who despite being at a critical crossroad still deserves to be treated with dignity and accorded all his/her inalienable rights and, amongst those rights is the provision of holistic medical service of which quality psycho-social supports and mental health are fundamental component. It is even more important that Ebola victims have access to professional counseling because they are not just victims of physical illness but victims of gross discrimination and abject neglect in the truest sense of the word. They in most cases are preys to minor depression which speedily degenerate into acute depression which science have proven is a staunch barrier to physical healing which originates from the mind.
From my experience of working with clients in refugee camps, prisons, ghettoes, hospital and, even victims in the very E.L.W.A. Ebola Treatment Unit, records have shown that patients and clients who were given quality psycho-social supports tend develop positive mindset which catapulted their healing. Dr. Philip Z. Ireland of the J.F.K.Medical Center (an Ebola survivor treated at the E.L.W.A Center) who I visited and spent a little over two hours chatting with this morning put it this way; “Smith, when I saw you at the center talking to me through the window I was not surprised and was happy, but when I saw you in PPEs in my isolation room in the center my spirit was elated”.
Staffers at the center showed me profound gratitude via their sincere thanks and appreciation every time I humbly walked out of the unit after being disinfected. Some said, my counseling makes their works with their patients easier. The specialization of labor applies everywhere if we want to score the needed victory. Show me a high spirited patient of any sort of illness and I will with ease show you a client/patient who stands a greater chance of survival. The records are there and backed by daily manifestations that a positive mind frame significantly influences prognosis of patients. Every Ebola victim or suspected victim goes through an unprecedented mental torture which is exacerbated by the rational yet degrading process of being quarantined and subjected to rigorous treatment rudiments.
In most cases, at least 75% of people in such conditions if not given adequate supports succumb to their adversaries which are not just the actual disease but shame, hopelessness, depression, anger and, the loss of self –esteem. All of aforementioned adversaries can be defeated and dignity, hope, health and national pride be restored by diligently and assiduously providing essential psycho-social counseling for a victim who is equally Liberia as those whose inept denies them their rights to holistic medical treatment.
In my Sociology 215 Class at the A.M.E.Zion University, I teach my students that one of the fundamental functions of the family is the provision of protection and supports for its members. Sadly, contrary is that focal norm and function in an Ebola related situation. Woe betides anyone who thinks that that mother, father, brother, sister, and, even a friend who helplessly with undeserved guilt stands in awe and shock as his/her love one gradually die mentally and then physically in one of the most humiliating fashions our nation has ever witnessed returns home a normal being. They are never the same again and need ardent and urgent psycho-social supports.
When our love ones are even suspected of Ebola we are mentally unstable because we for some genuine yet unbearable reasons stand and look by without giving the expected helping hands. This gives us guilt which in the first place is unwarranted but if not treated will lead to anger, fear, depression and then the biggest of all, stigma. The families of suspected, confirmed, and dead victims are mentally torn apart by discrimination, profound grief, anger and all sort of mental odds. Our national fight against Ebola must also practically not theoretically include the provision of the requisite means for treating and alleviating traumas that engulf families of victims.
Anything short of the said, is a gross and in some case calculated violation of their God-given rights as citizens of Liberia as inscribed in those sacred articles of our constitution. And, for this noble cause I’ve sworn to write, speak and act as the need is urgent and enormous. Are many bereaved families are on record for receiving substantial grief and transitional counseling as the results of the Ebola related death of their love ones? If at all any of such is being given, the numbers are shamefully dismal though our Ministry of Health and Social Welfare has on its payroll many mental health clinicians, social workers and psycho-social counselors. This too is alarming and raises eyebrow when we have our taxes being used to pay people whose impacts and expertise are supposed to be felt nationwide.
To my colleagues who are psycho-social counselors, mental health clinicians and social workers, there may be no appropriate time other than now to score your career and passion-to-serve indelible pluses and marks. Liberia needs you most and, let me remind you guys that you run the grievous risk of going down in our history as professionals who woefully failed to deliver when the nation and humanity needed you most. Think about this life ordeal of reproach upon you and your generation and act responsibly and ethically.
‘Front liners’, ‘national heroes’, ‘true patriots’ and ‘hard-working-health-workers’ and all sorts of flimsy and beauteous names we’re called in every corners but in all manner of sincerity, are we given the requisite gears to battle the foe? Are we justly paid what we worth proportional to the risks we take to serve in such difficult times? Oh my goodness, are our backs being watched while we go in harm ways even though we are ill equipped? What about the vital psycho-social supports we need as we watch hopelessly while our colleagues died and we cannot help? At this point, I am constrained to be blunt and not sugar-coat my words because this aspect hits me hardest daily.
When Dr. Samuel S. Brisbane, Sr., Dr. Abraham Borbor, Dr. Melvin Korkor, Physician Assistant Stephen Vincent, nurses, lab technicians and other health workers nationwide were ill and painfully away from their distressed families were their families given supports? Oh yes, when enough of those men and women who conscientiously gave their lives and services to this great nation died in and under ghastly fashion, were their families given sufficient psycho-social supports? A resounding no is the very unfortunate answer! Even more frustrating, while health workers who might have been the bread winners, ‘fortress of hope’ and source of joy and inspiration for their families walked the dreadful and faint-hope path of Ebola to which they eventually succumbed, were their families given supports?
Come to think about it, those colleagues with whom we worked and saw died were people, some of whom we have worked with for ages. We built irreplaceable bonds with many of them and, their death no doubt swept us off balance. Don’t those responsible at the Ministry of Health and Social Welfare and at the level of the Ebola National Task Force think we need quality and comprehensive psycho-social supports? Indeed we need lest we get overwhelmed by our losses and do provide poor health related services. That too is very detrimental to us and those patients and clients we care and provide services for.
Still put, as we daily provide quality services to our patients and client under stringent conditions, we experience vicarious trauma which requires the expertise of professional counselors to treat. Vicarious trauma is a severe form trauma experienced by care givers and health workers as the result of being expose to exceedingly horrible scenes and situations in the course of discharging their noble duties. Assessing, treating, counseling and several ways working with patients and clients in this perilous time is an ideal settling and breeding ground for vicarious trauma.
For goodness sake, do we expect to win this national fight against Ebola when in fact a patriotic PA, nurse, hygienist and a Dr. Jerry Brown who brave the storm to go into the Ebola Treatment Unit is burdened and overloaded with their job plus the works of those psycho-social counselors/mental health clinicians/social workers who are being paid but have never entered the unit in PPEs to provide quality psycho-social supports? Comically yet outrageously enough psycho-social supports is being provided the patients and their relative in an unique style that is only seen, overlooked thereby endorsed by our ‘authorities’. And, this is how quality psycho-social services are provided our people at the ELWA Isolation Center…..
In the face of extreme frustration and agony, our traumatized victims’ families daily are being boisterously insulted verbally and emotionally by a ‘doctor’ who in the truest sense is the E.T.U’s infuriating disgusting ‘public relations officer’ (PRO). When this erratic ‘Dr.’ who is being paid our tax payers’ money to be in the E.T.U treating patients crying for attention instead chooses to insult and grossly disrespect patients relatives, my bosses and other professionals like me who have cardinal part to play in our fight against Ebola, he’s providing ‘quality’ psycho-social services. Only in Liberia can this unprecedented and inhumane madness happen and go unchecked.
Our ill remuneration methodology is a direct contradiction to all the ‘loud’ and vain promises of incentive and motivational packages of health workers. Even my seven-year-old twin boys have been more motivational as theirs was demonstrated in words and deeds: those little ones once said to me on the phone, “daddy, we are praying for you oh and we have candies for you yeh”. Again, those at the ‘top’ need to take heed; pay my little boys consultancy fees and follow their example. Where are the incentive and motivational packages promised health workers? In the face of a national economy strangulation which have given birth to increment the in mental and physical hardships which potentially lowered our efficiency, isn’t it prudent to give us our just pay and incentives?
No doubt it’s always a rewarding venture to do so. By doing so, Mama Liberia increases her chance of having an already demoralized, fearful and ill equipped group of health workers stimulated to muster up the courage to serve. When Dr. Kent Brantly and his colleague Nancy chose to donned their PPEs, entered and served at the E.L.W.A. Ebola Treatment Center, they fearlessly did so for many reasons but paramount amongst those reasons was the glaring and established fact that they were (all Americans are) sure and convicted that though they were going through harm way, yet in the worst case scenario their government Uncle Sam would infinitely watch their backs.
You are all witnesses to the reality that when the worst situation occurred Uncle Sam never defaulted on her promises that are inscribed in their sacred constitution. They were given quality treatments in all ramifications and, eventually airlifted and treated in the best facilities. Dare not raise the lazy argument that we lack the capacity to follow suit ; because when same happened before our eyes, our heroes and heroines were not given the best of treatments proportional to our capacity. Again, only in Liberia have I seen this happened and go unchecked all of my professional life.
Am I one of those who have loss hope and faith in Mama Liberia? Emphatically, the known answer is no! Who dare thinks that I am that pessimist who thinks our national government isn’t scoring marks in our national fight? Instead, I am one of the many faithful and hopelessly hopeful youthful Liberian professions who still believe that despite the odds and unfavorable figures and data, Liberia can still score a memorable win in this deadly and fierce fight against the Ebola virus disease.
How can we still score a win? The below are my candid recommendations from my career perspective:
· Redefine the role of psycho-social supports in our national strategy and fight against Ebola and get the requisite and competent mental health clinicians, social workers and counselors trained and on board speedily.
· In an earnest effort to monitor and evaluate the works of the trained care givers, constitute, empower and well fund a robust psycho-social supports technical team made of people with proven experiences and reliable track records.
· Assigned at least four social workers or psycho-social counselors to every E.T.U., the said number can be increased or decreased relative to the size of the unit. And, let it also be spelt out that they are professional people whose views should respected and given access to the unit. The will eradicate the uncalled hurdles and frustrations I faced at the E.L.W.A. Ebola Treatment Unit in the discharge of my much needed functions.
· Let victims in the units, survivors of the disease and their families at some point in time as soon as possible have duly access to psycho-social supports.
· Hire and train data entry clerks and four data analysts to track and analyze data as it relates to survivors, patients’ death, their families’ locations and contacts, and the frequency of counseling sessions provided them. The hired data entry clerks and analysts will be deployed regionally, monitored and evaluated weekly.
· Without unnecessary bureaucracy, pay health workers our handsome overdue salary which they in fact deserve and add some incentive to motivate us.
· Enforce the rewarding practice of debriefing, self-care and vicarious trauma counseling session for all staffers at the unit as will be recommended by the psycho-social supports technical team and implemented by the psycho-social counselors assigned at the unit.
Achieving the above mentioned isn’t done by simply spinning a magic wane; there are obviously hurdles and constrains of all sorts yet I am of the staunch convictions that if the right people are first put in the right places, empowered, monitored and listened to, we as a nation can overall prevail against Ebola and other foes as we have with sweat, blood and diligence overcome in the past.. God bless Mama Liberia, God bless our leaders and God bless those bereaved and aggrieved families of victims, survivors and all health workers
About the author: Ernest Garnark Smith, Jr. is a psycho-social counselor, social worker, freelance poet, blogger, university lecturer, advocate and motivational speaker who is exceptionally passionate about his calling/job/career. He can be easily reached at: +231886824826/775709161 and email: email@example.comfirstname.lastname@example.org