Exclusive: How Sierra Leone learned lessons from Ebola
By Tian Jiao Lim and Joshua Chambers
And what this means for Covid-19.
Sierra Leone has many problems to solve. The West African nation suffered from a decade-long civil war in the 1990s that displaced half the population and killed 70,000 people. Peace brought about nascent economic recovery, and then came Ebola in 2014.
Sengeh was studying for a PhD at the Massachusetts Institute of Technology at this time, designing prosthetic limbs, inspired by the victims of war. He later worked with IBM as a research scientist, building AI-enabled systems for disease management in Africa.
Now he is leading innovation across the nation. Sengeh shared with GovInsider how he approaches this task, and why he doesn’t think that so-called ‘expert consultants’ are particularly useful at all.
After an epidemic
From a global perspective, Sierra Leone has valuable experience of containing, and recovering from, an epidemic. In 2014, Ebola spread rapidly across West Africa with exponential growth.
As then-US Ambassador to the United Nations, Samantha Power, writes in her autobiography, the economy was in “complete freefall and unemployment surging”, with tens of thousands of deaths and many more likely unreported.
But the risks were contained. The US Government had predicted that 1.4 million could catch the deadly infection, so its containment is a remarkable success story.
This experience has shaped the nation’s reaction to Covid-19. In particular, it emphasised the importance of international partnerships. “Sierra Leone's economy is weak. We had lots of support from external government bodies and organizations, and there was resilience of the people,” Sengeh says.
“No one entity can do it alone. You need to mix up local resilience and international partnerships and multilateralism.”
Ebola also underpinned the importance of public hygiene to prevent the spread of infection, Sengeh says. “Very early before we had our first case here, there were hand-washing buckets all over. We've activated our engagement in schools and in the community, and we had border control routines that were well advanced in anticipation of the disease.”
Sengeh runs an innovation movement from the heart of government. Some innovations are low-tech but high impact, keeping the nation going during a pandemic.
As schools across the country closed their doors, Sierra Leone has turned to a radio teaching programme. The daily broadcasts — first started in 2014 during the Ebola epidemic — teach “all education levels and nearly all subjects”. In Sierra Leone, where internet penetration remains low at 13% in 2019, such a programme is invaluable to students.
This year “we revamped the radio teaching programme some two weeks before schools closed, because we knew and anticipated that this would happen,” Sengeh says. They have also augmented the curriculum with music, meditation, and sexual and reproductive health classes. The innovation could prove useful for developing nations elsewhere, as it provides a basic standard to those at risk of being left behind.
Sierra Leone has also used an SMS alert system amidst the pandemic. This allows those without smartphones to keep abreast of the latest updates. “Our mobile-first approach tries to develop solutions that work for everyone, not just those who have smartphones or data, but those who have 2G connectivity with feature phones,” Sengeh comments.
Originally built for citizen engagement, Sengeh’s team has upgraded the platform to include Covid-19 specific solutions, such as pandemic updates, information on common symptoms, and self-assessment criteria. The self-assessment system has been used some “four million times over the last two months”, he says.
GovTech x Sierra Leone
As innovation chief, Sengeh heads the Directorate of Science, Technology and Innovation (DSTI). DSTI’s aim is twofold: to use innovation and technology to support Sierra Leone’s development, and to transform the country into an entrepreneurship hub.
For Sengeh, innovation has to come locally in order to be sustainable. To build this capacity, governments need to intentionally invest in technical expertise. “It’s about creating an ecosystem and inspiring people to believe that they too are the change,” he says.
Sengeh brings this mindset into his recruitment strategy at DSTI. The ability to process, analyse and solve problems is a must-have when selecting his team, he believes. “The way we problem-solve must reflect the world we live in — it’s not about the information that you have in your head.”
In this vein, Sengeh questions whether it is necessary for innovative roles and consultancy positions to require long years of work experience. “You’re not going to have a young person with a 10-year working experience,” he says. While experience is useful for some roles, governments should always ask themselves the rationale for these requirements, and whether it truly helps them “find a better candidate.”
Sengeh pushes his team through leading by example. “I still publish, I still write code with my colleagues, I still do user research,” he explains. “So it's easy to engage a group of young technical people on these things.”
The problem with consultants
Sengeh feels this support is not always provided by international organisations. In 2019 he wrote a blog post called “How the ‘Expert’ Consulting Complex Keeps Africa Stagnant”.
Developing nation governments often receive consultants from developed nations and non-governmental organisations as part of an aid package. These consultants frequently lack in-depth technical knowledge, Sengeh observed. However, they can successfully persuade governments to invest in costly tech solutions.
“Many of these experts have never written code in their lives, yet they talk about how blockchain might change water supply systems in Africa...They wouldn’t be able to draw up a single architectural framework for data structures, yet if you read their reports, you’ll find those words there,” Sengeh wrote.
“A combination of them using the right words, and the lack of technical expertise within our own governments, is why most of the aid money gets spent back externally on human expertise as consultants instead of building the institutions.”
There is a place for policy experts, of course. But “if we only have only one type of people who are solving these problems, then we have bottlenecks and we don't go as fast,” he tells GovInsider. “The teams we put together must be well-balanced”.
For international organisations to truly make a difference, they need to “make a commitment that most of the resources have to be spent in the country”. This would allow countries to focus their innovation efforts inward, to cultivate a core of motivated local problem-solvers.
And this is exactly what Sierra Leone is doing — strengthening their institutions step by step, with no shortage of creativity and passion to tackle issues close to their heart. “Ultimately, there’s a goal. The goal is that there will be quality education, that we will digitize the system, that we will change the structure of the people who are there, that we will have innovative policies,” Sengeh says.
It doesn’t matter whether people think it’s possible, he continues. “We will digitise the system and we will restructure it.”
Images by IBM Research — CC BY-ND 2.0, UK Department for International Development — CC BY 2.0, and Grace Kargobai/ Ministry of Basic and Senior Secondary Education