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