Freetown

Sierra Leone tries to scare public into stopping ebola spread

From the Guardian: ‘Western area surge’ will use similar tactics to UK drink-driving campaigns to scare people into changing their behaviour

A Sierra Leonean health worker carries the body of a child for burial

A Sierra Leonean health worker carries the body of a child for burial. Swab tests show that 30% of bodies picked up by burial teams are positive for Ebola. Photograph: Francisco Leong/AFP/Getty Images

The president of Sierra Leone will launch a massive campaign on Wednesday to curb the spread of Ebola in the western areas of the capital Freetown, which will aim to scare people into changing their behaviour.

The “western area surge” will use the sort of tactics that worked in the UK to discourage drink-driving, according to Donal Brown, head of the UK taskforce leading the international response in the country.

“We have got to go into every street, every house everywhere,” said Brown. “The western area surge is about massive social mobilisation and massive surveillance. “Freetown is not a place that feels scared or where people are bothered about Ebola. It is like the car crash or drink-driving campaigns in the UK. We want a campaign that says this is scary, this affects me – along the lines of, ‘Your neighbour stays at home? He kills you.’”

At the moment, swab tests show that 30% of bodies picked up by burial teams after calls from families are positive for Ebola. People are still nursing the sick rather than having them taken to holding centres for testing and then moved into treatment centres where half will probably die. It is in the last stages of the disease that victims are most infectious.

“We know it is out there. We have got to turn it around so that 2% to 3% of these bodies are actually positive,” said Brown.

The reluctance to make the call is rooted not only in family values but also cultural tradition around burials. In normal times, relatives would wash the bodies of those who die and dress them for the funeral. Many are still doing so – and calling the authorities afterwards, which means they have already exposed themselves to great risk.

“The behaviour change is not working,” said Brown. “We need to get to much more active surveillance, rather than passive surveillance.” Many thousands of people will be employed to visit communities and spread a tough new message in the course of the campaign, which will last for two to three weeks over the Christmas period. People now understand what Ebola is and what the risks are, but they are still in denial because they do not think it will happen to them, he said.

The latest data from the World Health Organisation shows a drop in the number of new cases in Sierra Leone, including Freetown, which may herald a flattening of the epidemic in the country as happened in Liberia – though it is also possible that the numbers will shoot up again as they did after dropping in Guinea. Last week there were about 250 fewer new cases in Sierra Leone, including a drop of about 100 in Freetown.

But as long as there are cases, there is the possibility of spread to a new region, triggering another outbreak. That has recently happened in rural Kono and in Kambia, the district north of Port Loko, which are causing real concern. In Kono in the eastern province bordering Guinea, it is thought men from Ebola-hit areas travelling for illegal diamond mining may have been a factor in the sudden outbreak.

Kono was unprepared. Some of the infections happened in a building being used as an isolation centre, where people who will have had other illnesses with similar symptoms such as malaria were being held with those who turned out to have Ebola. “We believe the spike is associated with unsafe burial practices and with poor infection control in a temporary holding centre,” said the UK’s Department for International Development.

The World Health Organisation reported 119 cases in Kono as of 9 December and said 87 bodies had been interred by burial teams stretched beyond their capacity before the alert was sounded and reinforcements drafted in.

Despite Aid, Ebola Raging in Sierra Leone

NOV. 27, 2014

KISSI TOWN, Sierra Leone — Military choppers thunder over the slums. Nearly a thousand British soldiers are on the scene, ferrying supplies and hammering together new Ebola clinics. Crates of food and medicine are flowing into the port, and planeloads of experts seem to arrive every day — Ugandan doctors, Chinese epidemiologists, Australian logisticians, even an ambulance specialist from London.

But none of it was reaching Isatu Sesay, a sick teenager. She flipped on her left side, then her right, writhing on a foam mattress, moaning, grimacing, mumbling and squinching her eyes in agony as if she were being stabbed. Her family and neighbors called an Ebola hotline more than 35 times, desperate for an ambulance.

For three days straight, Isatu’s mother did not leave her post on the porch, face gaunt, arms slack, eyes fixed up the road toward the capital, Freetown, where the Ebola command center was less than 45 minutes away.

“This is nonsense,” said M.C. Kabia, coordinator of the volunteer Ebola task force in Isatu’s area. Help rarely came, he said, and people were quietly dying all over the place.

While health officials say they are making headway against the Ebola epidemic in neighboring Liberia, the disease is still raging in Sierra Leone, despite the big international push. In November alone, the World Health Organization has reported more than 1,800 new cases in this country, about three times as many as in Liberia, which until recently had been the center of the outbreak.

More than six weeks ago, international health officials conceded that they were overwhelmed in Sierra Leone and reluctantlyannounced a Plan B. Until enough hospital beds could be built here, they pledged to at least help families tend to their sick loved ones at home.

The health officials admitted Plan B was a major defeat, but said the approach would only be temporary and promised to supply basics like protective gloves, painkillers and rehydration salts.

Even that did not happen in Isatu’s case. Nobody brought her food. Nobody brought her any rehydration salts or Tylenol. No health workers ever talked to her about who she might have touched, which means anyone directly connected to her could now be walking through Freetown’s teeming streets, where — despite the government’s A.B.C. campaign, Avoid Body Contact — people continue to give high fives, hug and kiss in public.

Community volunteers said Isatu’s case was the norm, not the exception.

“We have a huge number of death cases,” said Mr. Kabia, the volunteer Ebola coordinator in Isatu’s area, Kissi Town, adding that residents rarely survived because of the slow response.

Photo

On Freetown’s outskirts, burly youth are setting up roadblocks. The police are nowhere to be found. The young men barricade the road brandishing digital thermometers. CreditDaniel Berehulak for The New York Times

Discouraged, scared and furious, Sierra Leoneans are taking matters into their own hands. Laid-off teachers (all schools in this country are closed) race around on motorbikes, monitoring the sick. In some villages, informal isolation centers are popping up, with citizens quarantining one another, an incredibly dangerous ad hoc solution being performed without appropriate protection. (United Nations officials say this country is still short hundreds of thousands of protective suits.)

On Freetown’s outskirts, burly youth are setting up roadblocks. The police are nowhere to be found. The young men barricade the road, but instead of wielding weapons, they brandish infrared thermometers.

“Show me your forehead,” commanded a ringleader, wearing a white tank top and baseball cap askew.

A passenger leaned out of the car while the ringleader scanned his head. 98.5. The posse then lifted the barricade, keeping anyone sick out of their neighborhood.

Fever is the scarlet letter of Ebola. Just about every important building in Freetown — hotels, banks, government offices — is now manned by a guard with an infrared thermometer and a bucket of diluted bleach for a mandatory hand wash.

But in the slums, it is a different story. In Kissi Town, an underserved area of dirt roads and dirty wells, the local Ebola task force said that more than 150 people had recently died of the virus, and that many had received no food, medicine or any other help.

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Ebola patients waited in the recovery area after testing negative for the virus at a treatment center in Freetown, Sierra Leone. CreditDaniel Berehulak for The New York Times

Stuck in her house, waiting for an ambulance, Isatu kept burning up. She was intensely nauseated, she said, but still able to walk a few steps, an important factor.

“If they walk in, their chances are good,” said Komba Songu M’Briwa, a doctor at an Ebola clinic. “If they have to be carried in, well …”

By last Friday morning, Isatu was not walking anywhere. She had become too weak to stand. Her chances were plummeting.

She curled up on the floor, her jeans splotched with dried black vomit. She was delirious, eyes bolted open, huge and blank. A shadow would cross the threshold and they would not even flicker.

The virus was moving faster than all the aid workers put together.

“I’ve called 10 times myself, ” said Abu Bakar Kamara, a community volunteer, as he paced the scratched dirt yard in front of Isatu’s house. “No response.”

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Health workers outside the high-risk area at the Hastings Ebola treatment unit in Freetown, the capital of Sierra Leone. CreditDaniel Berehulak for The New York Times

Sierra Leone has an elaborate Ebola response system — on paper. It starts with a call to 117, the toll-free number for central dispatch. A surveillance team is sent out, then an ambulance takes a patient to a holding center, then blood tests and a proper treatment center where the patient might receive intravenous fluids or other special care.

But the Ebola clinics do not have nearly enough beds, especially in Freetown, and an ambulance will not show up at a sick person’s house unless there is a bed somewhere for that patient. The government says it needs 3,000 beds nationwide but has fewer than half of that now.

Ambulances are hurtling across the country for hours to remote clinics in the east, where there are a few vacancies. The roads are horrendously bumpy; the jungle heat without reprieve. Many patients are dead on arrival.

Western officials are quick to add that even if all the resources were in the right place, that would not stop the virus.

“You can have as many helicopters, ships and kit here as you’d like,” said Lt. Colonel Matt Petersen, a British adviser. “But unless you change behavior, it’s not going to stop transmission.”

Public health professionals are beginning to look harder at Sierra Leone’s culture, which is dominated by secret men’s and women’s societies that have certain rituals, especially around burials. Many people here — just like in other cultures — believe that the afterlife is more important than this one. A proper burial, in which the body is touched and carefully washed, is the best way to ensure a soul reaches its destination.

Daily ebola reporting from Freetown via OnOurRadar

Reposted from ebola.OnOurRadar.org

Riots in Kono after Ebola team intervention

– Mariama Jalloh, Kabala

“There was riot in Kono yesterday…I heard the information in the night so I called my friend living in Kono to find out more. According to her, an old woman was sick and the Ebola team came to carry her away. Her relatives refused, so there was a quarrel which locals got involved with. The police started firing and two civilians allegedly lost their lives.”

“They said they are going to stay in the forest as they will be better able to protect themselves from this trouble”

– Mariama Jalloh

Coping is not easy – in fact, I want to share this story with you:

I met two women in the market buying some basic things. They said they are going to stay in the forest with their family, as they will be better able to protect themselves from this trouble.

They said the illness is worse than the war, because we cannot see it.

“We are determined to fight to win back our status as an Ebola-free district”

“We are so worried…we are in trouble now… Everybody is praying for survival.”

Sierra Leone’s Koinadugu district was the only district in the country to have successfully kept the Ebola virus at bay, until Wednesday when two cases were confirmed. This has caused panic in the community.

John F Sillah reports on the community’s response and their determination to regain its status as an Ebola free district.

Read the full story on Channel 4 News: 

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“People are beginning to think Ebola is a man made disease”

-Mohamed Camara

People are beginning to think Ebola is a man made disease as only man made diseases have an end date and natural diseases do not.

The local radio show Monologue, mostly listened to by Sierra Leoneans revealed that, according to the government, Ebola will be eradicated by November. The show also said that some patients who have been admitted are not Ebola positive.

“The 117 team says people are responsible of complaints about corpses left on the streets”

On Tuesday in Freetown clashes broke out between security forces and people protesting against delays in removing a corpse of an Ebola victim.

– Mohamed Kamara

The 117 team said the people are responsible because when they are called and arrive to collect a corpse, people stop them and they must provide the results [if it is an Ebola case or not] before going away with the body, so this is why there are complaints about corpses left in the streets.

“In this part of the country most students don’t own radios”

-Moses Kortu 

In this part of the country, students are not able to listen to the radio; most of them don’t own radios. This is farming time, parents are looking for food- how will they tell their children to listen when there is no food at home. Generally, children in this community are not benefiting from it.

“The country’s level of education is very poor and not all parents are educated to guide their children”

Sierra Leone government officials launch a project that offers lessons via the radio for children as schools are closed indefinitely.

-Mohamed Camara 

The education program on the radio is not really necessary for primary school because when we take a look at the country’s level of education, it is very poor and not all parents are educated to guide their children. Not all parents listen to the radio nor have someone to stay by their kids, and because of all this my mother said she will prefer my young brother to wait until school reopens and will not waste time on the radio.

 

“The ban of bike riders (“okada”) has been lifted on the 11th of October in the city of Makeni.”

– Sixty Kamara

The ban of bike riders (“okada”) has been lifted on the 11th of October in the city of Makeni by the Resident Minister-North Alie D. Kamara. As reported previously, on the 29th of September there were false rumours about the end of Ebola spread by bike riders. This led to the ban. Now the Minister raised four points regulating bikes circulation: bikes must be licenced and insured; there will be no underage riders allowed; bikes must be registered; and riders should obtain licences. Above all, only bike riders are allowed to travel between 7 am and 7 pm.

“Workers have threatened to down their tools today following the non-payment of their allowances”

– Abu Bakarr Kargbo

Workers at the Ebola case management centre at the government hospital in Kenema have threatened to down their tools today following the non-payment of their allowances for over four weeks now. It has been confirmed that the Ebola case management centre at the government hospital in Kenema is presently housing 7 confirmed Ebola patients and  10 awaiting laboratory results.

313 children in Sierra Leone have lost their parents to Ebola

(image: Tamba Tengbeh)

-Tamba Tengbeh 

The Sierra Leone Association of Non-Governmental Organisations (SLANGO) meet to discuss the role of the Ministry of Social Welfare towards orphans who lost their parents due to the Ebola epidemic.

There are 313 orphans in Sierra Leone so far, according to the Gender Advocacy Officer, the Ebola focal person, and the Ministry of Social Welfare.

 

“The way cars and vans were overloaded is my concern…touching, sweating might be [fateful]“

-Sixty Camara 

Muslims prayed their congregational prayers in different places including the town field (Wusum) during Eid, where they took water and soap and even preached on the preventive methods of the epidemic. But the way cars and vans were overloaded is my concern, as the touching, sweating might be [fateful] if ebola affected are amongst.

Ebola headlines and local report wrap up, Sep 8 2014

African Union says efforts to stop Ebola are creating sense of siege

MONROVIA, Liberia – The United States and Britain will send medical equipment and military personnel to help contain West Africa’s Ebola outbreak, as the World Health Organization warned Monday that many thousands of new infections are expected in Liberia in the coming weeks.

The current Ebola outbreak is the largest on record. It has spread from Guinea to Sierra Leone, Liberia, Nigeria and Senegal and killed more than 2,000 people. An “exponential increase” in new cases is expected in the hardest-hit countries in coming weeks, the U.N. health agency warned.

“As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload,” WHO said in a statement about the situation in Liberia. “Many thousands of new cases are expected in Liberia over the coming three weeks.”

Military personnel will set up a 25-bed field hospital in the Liberian capital, Col. Steven Warren, a Pentagon spokesman, said Monday. The clinic will be used to treat health care workers, a high number of whom have become infected in this outbreak.

Once set up, the centre will be turned over to the Liberian government. There is no plan to staff it with U.S. military personnel, Warren said.

Liberia welcomed the news.

“This is not Liberia’s particular fight; it is a fight that the international community must engage very, very seriously and bring all possible resources to bear,” said Information Minister Lewis Brown.

In addition, Britain will open a 62-bed treatment centre in Sierra Leone in the coming weeks. It will be operated by military engineers and medical staff with help from the charity Save the Children, Britain’s Department for International Development said Monday.

The clinic will also include a special section for treating health care workers, offering them high-quality, specialist care, the statement said.

Currently, there are about 570 beds in Ebola treatment centres in Guinea, Sierra Leone and Liberia, the hardest-hit countries, and the World Health Organization says nearly 1,000 more are needed, the vast majority of those in Liberia.

Doctors Without Borders welcomed both the American and British announcements, but warned even the latest surge in efforts may not be enough, saying the disease was moving “catastrophically through the population much faster than new facilities are being created.”

And experts say it’s not just beds, but that more international and local health workers that are needed. Doctors Without Borders also urged Washington to not simply set up clinics but also to staff them.

Many health workers, however, have been reluctant to respond to the crisis out of concern that there isn’t enough protective equipment to keep them safe.

A fourth American who contracted Ebola in West Africa was expected to arrive in the U.S. for care Tuesday, Emory University Hospital — where two other aid workers successfully recovered from the disease — said Monday in a news release.

Ebola is spread through the bodily fluids of people who show symptoms, and doctors and nurses are at high risk of infection because they work closely with the sick. The WHO doctor whose infection was announced Monday is the second health care worker with the agency to catch Ebola. The doctor is in stable condition and will shortly be evacuated, the agency said.

In Liberia alone, 152 health care workers have been infected with Ebola and 79 have died, WHO said, noting that country had too few doctors and nurses even before the crisis.

“Every infection or death of a doctor or nurse depletes response capacity significantly,” it said.

U.N. Secretary-General Ban Ki-moon called several world leaders over the weekend, including the British prime minister and French president, to urge them to send more medical teams and money to fight the outbreak.

Officials have said flight bans and border closures — meant to stop the disease’s spread — are slowing the flow of aid and protective gear for doctors and nurses to the region.

At an emergency African Union meeting Monday, members agreed to open borders that have been closed and lift bans on flights to and from affected countries, according to Nkosazana Dlamini Zuma, chair of the AU’s Commission. But it was unclear how quickly those promises would be kept.

Earlier, Senegal, which has shut its borders and blocked flights, said it was planning to open a “humanitarian corridor” to the affected countries.

Liberia: Govt. Suspends Poro, Sande Activities

The Ministry of Internal Affairs through its Bureau of Customs and Culture and in collaboration with the National Council of Chiefs and Elders has announced the immediate suspension of all Poro and Sande activities throughout Liberia.

Sande, also known as zadεgi, bundu, bundo and bondo, is a women’s association found in Liberia, Sierra Leone andGuinea that initiates girls into adulthood, confers fertility, instills notions of morality and proper sexual comportment, and maintains an interest in the well-being of its members throughout their lives. In addition, Sande champions women’s social and political interests and promotes their solidarity vis-a-vis the Poro, a complementary institution for men. The Sande society masquerade is a rare and perhaps unique African example of a wooden face mask controlled exclusively by women – a feature that highlights the extraordinary social position of women in this geographical region.

The ministry says its attention has been drawn to reports of the continued operation of Poro and Sande societies in several parts of the country in violation of the moratorium placed on the operation of Poro and Sande Societies on June 2, 2014.

In a press release issued here, it said the decision then, and now, was intended to ensure that there is no outbreak of the Ebola virus in any Poro or Sande grove in Liberia.“This would be a disaster and it must be prevented in the interest of saving additional lives of our fellow citizens”, the release read. However, the ministry notes that in spite of its demonstration of understanding and accommodation, some individuals have continued to operate Poro and Sande Groves and conduct cultural festivals.

According to the press release signed by Minister Morris Dukuly, such practices in the face of the Ebola epidemic exposes citizens to increased incidents of the virus and untimely death. The ministry therefore directs that all such practices must cease and be seen to have ceased by September 17, 2014.

MIA warns that any grove which operates or reopens its doors to initiate persons will be seen to be in defiance of its General Circular No. 13 and its most recent statement, reaffirming the provisions of the General Circular.

The Ministry says, the two-week extension it is granted under this statement is to allow the smooth closure of all Poro and Sande Societies operating in the country, and should not be viewed as an extension of the term of existing graves.

It said any grove or society found operating beyond the September 17, 2014, date would be ordered immediately closed in keeping with cultural, traditional practices, and its guidelines and regulations, while persons operating such groves will be prosecuted under the laws of Liberia.

Meanwhile, the Minister of Internal Affairs is authorizing all county Superintendents, District Commissioners, County Inspectors, and other appropriate local government officers ensure full compliance with this directive, and to close uncooperative Sande and Poro Societies upon the expiration of the two-week extension period.

The release said the Minister of Internal Affairs has written to inform Chief Zanzan Karwor, Chairman of the National Council of Chiefs and Elders, of the directive, and requested the full cooperation of the council.

Monrovia – The deadly Ebola virus is spreading in Monrovia and beyond, touching the security sector as 18 Police officers have been quarantined in Bloc C at the Police Barracks in Monrovia.

According to sources, one Police officer serving the Police Support Unit (PSU) contracted the virus and is currently undergoing treatment at the ELWA Ebola center.

One senior Police source confirmed to FrontPageAfrica that the officer is in critical condition at the Ebola treatment center. The Police officer is said to have contracted the virus from his wife who is a nurse, who transferred the virus to her husband after also getting infested from work.

The health of the PSU officer prompted the quarantining of Bloc C of the Police barracks where accordingly the 18 Police officers are residing. Located at the intersection of Camp Johnson Road and Capitol By-pass the Police Barracks is home to several Police officers and their dependents.

According to one member of the Ebola Task Force, several items have been supplied the quarantined Police officers including chlorine, biscuits and other materials. Police officers are used in protecting clinics and other medical facilities also accompanying various medical teams, including burial, collection of sick patients and others.

The officers are usually not seen wearing protective gears including gloves and other PPEs while providing protection in medical facilities and carrying out other duties closely related to Ebola. Police officers are also used to implement quarantine in several communities as they were recently deployed to ensure the quarantine of the West Point community and some are now in Dolo’s Town, Margibi County performing similar duty.

United States based Centers for Disease Control has warned that up to 20,000 people will get infested with the virus before it is brought under control, but it seems the Liberian government does not agree with such prediction as President Ellen Johnson Sirleaf has publicly declared disagreement with the CDC’s prediction.

Despite disbursement of funding from the Ebola fund to the security sector including the Police, Police officers are not adequately catered for as some officers have complained that they do not receive daily per diems and other protective materials, thus making vulnerable to contracting the virus.