Monrovia

Time person of the year: Racing to end ebola

NEW JERSEY – Katie Meyler, Founder of More Than Me, joins the Ebola Fighters named  TIME’s Persons of the Year with her work highlighted in the Ebola Caregivers list. Meyler and the Ebola Fighters group join a list that in the past has recognized Winston Churchill, Ghandi, Pope Francis, and President Obama.

“The past few months have been filled with some of the most intense moments of my life, but they’ve also been some of the proudest. I’m honored to be listed next to these truly inspiring people and want to take this time to recognize everyone, on this list or not, who has helped fight Ebola on the front lines,” Meyler said.

This recognition comes out of great tragedy, but is a reminder of the need to continue the fight against Ebola until there are no new cases – and to move forward and rebuild as the epidemic ends. The mission of More Than Me has always been to expand educational opportunities for the most vulnerable girls from the West Point slum in Monrovia; but unable to stand by while their students were at risk, the organization shifted to rapid Ebola response programs in August. As Meyler puts it, “We don’t have an organization if we don’t have students who are alive.”

The tremendous efforts of Iris Martor, More Than Me’s school nurse turned Ebola Fighter, are also mentioned. While working in the community leading trainings to keep staff safe and coaching nurses, Martor’s 8-month-old girl became ill and she feared it was Ebola. When her daughter tested negative and recovered, Martor momentarily questioned the risk she was taking, but ultimately thought, “If someone from America comes to help my people, and someone from Uganda, then why can’t I? This is my country. I should take the first step.”

More Than Me is committed to caring for Monrovia communities that have been deeply affected by this outbreak. More Than Me’s team hopes to reopen their school and resume regular programming in early 2015, but is also committed to long-term support of survivors and the families of those affected by Ebola in their students’ communities. Next year, Meyler hopes to open a boarding school to offer a greater number of children an education including many Ebola orphans. Donations to support More Than Me’s work are matched until December 25th. Learn more here.

The TIME editors’ selection is based on “who best represents the news of the year,” spotlighting leaders who showcase “both a snapshot of where the world is and a picture of where it’s going.”

You can follow Katie’s daily experience at racingheartblog.tumblr.com and donate to MoreThanMe at GlobalGiving.

katie-meyler-dec-racingheart-blog

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Why the Texas case will not cause an ebola outbreak

I’ve scanned about 500 blog posts tagged #ebola since August 2014 and I can say with confidence that there are a lot of paranoid uninformed Americans out there. These fears are founded on misinformation and suspicion of the system designed to protect the public, not on facts. Here are the facts about yesterday’s case:

The system worked as it should

  • The Ebola carrier left Monrovia, Liberia (Sep 19) without symptoms and arrived in Dallas, Texas (Sep 20) without symptoms. His temperature was taken in both airports and did not indicate a fever.
  • Fever is one of the early symptoms of ebola. If a patient has no fever, he cannot spread ebola.
  • The carrier visited a hospital on Sep 24 with symptoms. This hospital was prepared for ebola, had briefed its staff, and had an isolation ward ready. Because the symptoms were run-of-the-mill flu stuff (no hemmoragic fever), he was sent home.
  • His family brought him back on Sunday, Sep 28 and he was admitted. His blood tested positive for the ebola virus. PCR is a very precise test. Only a 99% exact DNA match will test positive.
  • All people who contacted him during the days he was contagious are being monitored for symptoms. It only included his direct household relatives.

Ebola can only be spread through direct contact. Ebola does not spread through the air. So the only people who could be exposed are known and being monitored.

Why USA is different from Liberia

  • Access to healthcare is much better in America. There is one doctor for every 400 Americans, compared to one doctor for every 20,000 Liberians.
  • Every hospital bed in Liberia has been filled for weeks. Sick Liberians are not likely to visit a hospital anymore, and so the virus spreads faster there. For how the number of beds affects models to count the number of cases and predict disease spread, look at this academic paper. “By September 30, 2014, without additional interventions and using the described likelihood of going to an ETU, approximately 670 daily beds in use (1,700 corrected for underreporting) will be needed in Liberia and Sierra Leone (Figure 2).” There are an estimated 2.5 ebola sufferers for every one that got a hospital bed in September, 2014.
  • Obamacare has reversed the trend of making hospitals only available to the rich and the employed. At the moment, every seriously sick American (citizen or not) will go to a hospital for treatment, making quarantine possible. If large segments of society expect to be turned away from hospitals, denied treatment, they will stop coming, and ebola WILL spread in America.

Here is the CSPAN briefing about the Ebola case in Texas from September 30th:

ebola-texas-briefing-cspan

http://www.c-span.org/video/?c4510157/ebola-texas

Woman saves three relatives from Ebola

CNN – By Elizabeth Cohen, Senior Medical Correspondent, Fri September 26, 2014 – suggested reblog by How-Matters.com

Fatu Kekula has cared for four of her family members with Ebola, keeping three alive without infecting herself. Fatu Kekula has cared for four of her family members with Ebola, keeping three alive without infecting herself.

For more from Elizabeth Cohen on the ground in West Africa, watch CNN Saturday at 3 p.m. ET.

(CNN) — It can be exhausting nursing a child through a nasty bout with the flu, so imagine how 22-year-old Fatu Kekula felt nursing her entire family through Ebola.

Her father. Her mother. Her sister. Her cousin. Fatu took care of them all, single-handedly feeding them, cleaning them and giving them medications.

And she did so with remarkable success. Three out of her four patients survived. That’s a 25% death rate — considerably better than the estimated Ebola death rate of 70%.

Fatu stayed healthy, which is noteworthy considering that more than 300 health care workers have become infected with Ebola, and she didn’t even have personal protection equipment — those white space suits and goggles used in Ebola treatment units.

Instead Fatu, who’s in her final year of nursing school, invented her own equipment. International aid workers heard about Fatu’s “trash bag method” and are now teaching it to other West Africans who can’t get into hospitals and don’t have protective gear of their own.

Every day, several times a day for about two weeks, Fatu put trash bags over her socks and tied them in a knot over her calves. Then she put on a pair of rubber boots and then another set of trash bags over the boots.

She wrapped her hair in a pair of stockings and over that a trash bag. Next she donned a raincoat and four pairs of gloves on each hand, followed by a mask.

It was an arduous and time-consuming process, but Fatu was religious about it, never cutting corners.

UNICEF Spokeswoman Sarah Crowe said Fatu is amazing.

“Essentially this is a tale of how communities are doing things for themselves,” Crowe said. “Our approach is to listen and work with communities and help them do the best they can with what they have.”

Two doctors for 85,000 people

She emphasized, of course, that it would be better for patients to be in real hospitals with doctors and nurses in protective gear — it’s just that those things aren’t available to many West Africans.

No one knows that better than Fatu.

Her Ebola nightmare started Juy 27, when her father, Moses, had a spike in blood pressure. She took him to a hospital in their home city of Kakata.

A bed was free because a patient had just passed away. What no one realized at the time was that the patient had died of Ebola.

One woman walked in, and the Ebola nightmare began

Moses, 52, developed a fever, vomiting and diarrhea. Then the hospital closed down because nurses started dying of Ebola.

Fatu took her father to Monrovia, the capital city, about a 90-minute drive via difficult roads. Three hospitals turned him away because they were full.

She took him back to another hospital in Kakata. They said he had typhoid fever and did little for him, so Fatu took him home, where he infected three other family members: Fatu’s mother, Victoria, 57; Fatu’s sister, Vivian, 28, and their 14-year-old cousin who was living with them, Alfred Winnie.

Guilty of Ebola until proven otherwise

While operating her one-woman Ebola hospital for two weeks, Fatu consulted with their family doctor, who would talk to her on the phone, but wouldn’t come to the house. She gave them medicines she obtained from the local clinic and fluids through intravenous lines that she started.

At times, her patients’ blood pressure plummeted so low she feared they would die.

“I cried many times,” she said. “I said ‘God, you want to tell me I’m going to lose my entire family?’ “

But her father, mother, and sister rallied and were well on their way to recovery when space became available at JFK Medical Center on August 17. Alfred never recovered, though, and passed away at the hospital the next day.

“I’m very, very proud,” her father said. “She saved my life through the almighty God.”

Now he’s working to find a scholarship for Fatu so she can finish her final year of nursing school. He has no doubt his daughter will go on to save many more people during her life.

“I’m sure she’ll be a great giant of Liberia,” he said.

Ebola patients left to lay on the ground

CNN – By Elizabeth Cohen, Senior Medical Correspondent – Tue September 23, 2014
Watch this video

Ebola overwhelms new hospital in Liberia

Editor’s note: CNN senior medical correspondent Elizabeth Cohen is in Liberia to report on the largest Ebola outbreak on record.

Monrovia, Liberia (CNN) — On the day the new Ebola clinic in Liberia opened, ambulances waited outside. Inside the ambulances were desperately ill patients who had come for treatment but instead would be left to lie on the ground as others walked by.

The Island Clinic and its 120 Ebola treatment beds opened to fanfare Sunday afternoon, with a ceremony attended by international health officials and Liberian leaders. But the clinic, located on Bushrod Island near Monrovia, the capital, did not appear to be ready for the number of patients that quickly flooded its doors.

Some lay motionless on the floors of the ambulances outside the center, too weak to get out. They had traveled for hours after being turned away from other hospitals in the area. No one from inside the hospital arrived to offer assistance.

Photos: Ebola outbreak in West AfricaPhotos: Ebola outbreak in West Africa

“Try to come down and walk a little,” a worker told him.

“I’m too tired,” the man said.

But he summoned his strength and got out of the ambulance — and immediately collapsed on the ground.

A little boy tried to walk out of another ambulance, but he too collapsed.

The two lay on the rocky ground just a few feet apart. The boy was completely naked and the man was naked from the waist down — Ebola patients often don’t wear pants because of the intense diarrhea caused by the virus.

“Get up and go inside,” workers told the boy. “You’ll only get food if you go inside.”

“Let him rest,” another worker said, and they agreed to let him stay where he lay.

When asked why no one from the hospital was helping them get inside, a hospital worker said staff was inside suiting up in protective gear. Ebola spreads through contact with bodily fluids from an infected patient.

More than 2,800 people have died over the past six months in West Africa. Five countries have reported Ebola cases, but Liberia, Guinea and Sierra Leone have carried the largest burden.

Deadliest outbreak: What you need to know

Island Clinic is supported by the government of Liberia and the World Health Organization. When shown CNN’s video of the patients collapsing, a WHO representative was horrified, but said the patients shouldn’t have waited until they were so sick to seek help.

“I think the lesson here is that people come too late,” said Peter Graaff.

But many Ebola patients don’t wait by choice — there’s an estimated shortage of 700 Ebola beds in Monrovia alone, and patients often wander from hospital to hospital, only to be turned away.

“I know, I know,” said Graaff, WHO’s country representative in Liberia. “That’s why we need to increase capacity.”

Graaff said he would try to find out why hospital workers didn’t come help the patients. He said he hopes any opening-day difficulties won’t discourage patients from seeking help — he doesn’t want them to stay home.

“It’s shocking,” he said. “This is exactly what we should try to avoid in the future. It’s horrible.”

***

John Bonifield, Orlind Cooper, Orlando Ruiz and Jacque Wilson contributed to this story.

Fighting the Spread of Ebola in a Weak and Poor Governance Structure: A Liberian Peacebuilder’s Perspective

TEST

As the Ebola virus spreads throughout Liberia, the effects of bad governance, weak health infrastructure, mismanagement, and greed are manifest as death rates continue to surge. On September 23, the Center for Disease Control estimated that cases of Ebola in West Africa will double every 20 days — and in an absolute worst-case scenario without any intervention, the disease could infect 1.4 million by January. The government has lost control of the situation and is now dependent on the goodwill of the international community for both manpower and basic supplies.  For example, hospitals and government-run Ebola centers are plainly unable to handle the caseload — many suspected victims have been asked to return home due to lack of beds and unavailability of staff to care for them. At the same time, local organizations are engaging in awareness activities hoping to reach out to populations in Monrovia and beyond, but with little or no support from the government.

The Ebola virus epidemic started in Gueckedou, a city in Guinea near Voinjama in Liberia’s Lofa County. The index case of Liberia is suspected to have been a health worker who became infected while treating two suspected cases of Ebola in Liberia’s Foya Hospital near the country’s border with Guinea. This nurse was further alleged to have travelled to relatives in Margibi County, about an hour drive away from Monrovia and subsequently sought treatment at the Liberia’s Firestone Hospital in March 2014. The Liberian government declared the Ebola epidemic in middle of March when two out of four samples sent to Guinea for testing came back positive. The numerous further contacts  apparently among those that had interactions with the first victims and additional cases from Guinea to Liberia resulted in the first wave of the epidemic, which was mostly confined to Lofa County running from March to June. After a period of lull, there came a second outbreak in July which spread at a faster rate and engulfed the capital city of Monrovia.

Fighting the Spread of Ebola Nat B. Walker Building Peace Forum

The government reacted slowly. It appeared to expect the international community to do for Liberia what it should have done for its people during the early stage of the crisis. For instance, when international organizations mobilized to control the situation at the borders, senior government officials made pronouncements dismissing the claims that the outbreak was Ebola. When Médecins Sans Frontières (MSF) and Samaritan’s Purse fought to contain the virus, the government was unable even to support the establishment of a testing center. It took days to get test results from the only testing facility in the country and even as the virus spread, confirming results was a challenge as it remained the only testing facility for months. With the help of the international community, there are now three active testing centers.

Much later, in July of 2014 in an attempt to contain the situation, Liberia’s President Madam Ellen Johnson Sirleaf announced the formation of a national Task Force on Ebola, to be headed personally by her. But the Task Force idea appeared like another political decoration: it had no clear mandate, a very weak coordination structure.  It was a rapid response team with little or no logistical support and no involvement of local people.  The ineffectiveness of the government institutions on the task force and the overall poor and inadequate response to the crisis ultimately led to violence.

The virus spread and continued to claim lives daily, yet for almost three months, only two ambulances served the 1.5 million citizens of Montserrado County (the area around Monrovia). A popular Liberian politician aimed to help by providing a third ambulance, but it was instructed only to pick up sick people. The dead were left to rot, accumulating at alarming rates and contributing to infection.  Vehicles were quickly donated to government agencies by international organizations when government officials declined to contribute their luxurious, government vehicles to the urgent need. Community dwellers were forced to expose themselves to the virus by removing the bodies from their homes to the roadside because the response team had no logistics to respond to the many calls for help. For them, placing the bodies in the streets made their homes safer while urging the government to clear the streets, but many contracted the virus from the contact.

As the government continued to demonstrate inefficiency in containing the situation and failed even to communicate in a coordinated fashion, distressed and marginalized citizens took to the streets.  These attempts to spur government attention led to outbursts of violence. In late July, I witnessed residents of the St. Paul Bridge Community in Montserrado County block a major highway connecting the western region with the capital, demanding that the government remove five dead bodies from their community. Only then did the government-coordinated Ebola response team respond. More recently, on the capital by-pass road, less than two miles from the Executive Mansion, a similar situation occurred. In the meantime, angry citizens called in to radio shows (the most popular form of mass communication in the country) to narrate how they were forced to sleep in streets while waiting for the government to remove dead bodies from their homes. The authority and legitimacy of the government are constantly being questioned by the citizens because of how inadequately they have addressed the virus.

The government instituted a curfew from 9:00 PM to 6:00 AM, intended to prevent people from coming out at night to throw bodies in the streets or to secretly bury their dead. Later adjusted to 11:00 PM to 6:00 AM, the curfew still remains active, but for many, the official justification is not logical. If intended to prevent people from taking actions to remove dead bodies from their homes, why not focus on strengthening the capacity of the agencies responsible for gathering the sick and deceased?  Instead, armed robbers have taken advantage of the curfew by attacking homes at night, since the government-imposed curfew now prevents community dwellers from organizing community watch teams and security agencies lack the capacity to patrol communities at night.

A health worker at Island Clinic in  Monrovia, Liberia checks on a patient. (Photo Credit: Morgana Wingard, USAID via Flickr)

At the moment, there is better coordination with the arrival of international experts and the much-delayed appointment of a national coordinator to the government task force. Much of what the task force is now doing, it should have begun months ago and undoubtedly would have saved many lives. But serious challenges remain. The biggest of these is how to address the virus outside of Monrovia. Beyond the capital, there is no clear support to empower health workers and social mobilization committees to carry out community-driven response activities.  Allegations of bribery are also on the rise, indicating continued state inefficiency.  A member of a recent civil society team confirmed that he paid 400 Liberian dollars (less than five United States dollars) to security personnel at the checkpoint between Grand Bassa and Rivercess in order for his colleagues to pass through since one was traveling without identification. It is even alleged that members of the government response team are requesting bribes to pick up dead bodies from communities.

In the government’s fight against Ebola, there is also suspicion of financial mismanagement. Nurses and doctors, whose lives are most at risk, are still not receiving adequate compensation and have no life insurance or medical insurance. There have also been fears of abuse and waste when handling Ebola funds. The Head of the Anti-Corruption Commission recently warned that his agency is monitoring the flow of cash and that corrupt officials will be prosecuted. Unfortunately, a lot of skepticism remains about the political will of the commission — since its formation over eight years ago, it has not closed a single case of corruption in the interest of the Liberian citizens. It remains a toothless bulldog to the excitement of the establishment.

Unless the fight against the spread of Ebola is fully decentralized to the county, district, and community levels, and adequate support is provided to caregivers including health practitioners, we should expect many more people to die. This is a sad reality. The government and its partners should take keen note of this and consider identifying, strengthening, and supporting community-led structures, especially in counties not yet overpowered by the virus.

President Barack Obama’s pronouncement of 3,000 US troops to help contain the situation is highly welcomed, but I recommend  that, as a matter of policy, U.S. troops and other international actors be directed to exercise caution. Liberians are already disenchanted with the government’s poor handling of the crisis.  If care is not exercised, the anger of the citizens could easily be transferred from the government to international actors. Involving local civil society actors, especially grassroots organization is an essential factor to any international intervention. This will help address the negative perceptions and mistrust the public has in the government’s handling of the crisis. This critical step must be implemented at the very beginning of the process if the desire result is to be achieved swiftly.

Nat B. Walker is a development and peacebuilding consultant working in Liberia. Hired on a long-term basis by Humanity United and TrustAfrica, he is currently supporting the development and expansion of a community-based conflict early warning and response system in Liberia. Nat is also a Liberia correspondent for Insight on Conflict, a UK-based project of Peace Direct and has previously worked for international organizations including the Catholic Relief Services, Mercy Corps and Conservation International. He is also an adjunct faculty member at the Kofi Anaan Institute of Conflict Transformation at the University of Liberia.

IamA First Responder to the Ebola Virus outbreak in Liberia

Compiled from reddit’s IAmA live question and answer channel, hosted by Sean Casey on Sep 19, 2014:

Source: First responder transcriptMore than Me’s Katie Meyler transcript

Monrovia is generally like this: the food is spicy, the people are warm, the colors are bright. It has a complex history. The infrastructure was completely destroyed in a 14-year civil war and now they’re trying to rebuild.

Q: Is the situation out there as bad as the media portrays it to be?

Situation is indeed vey bad, several studies show that the number of cases double each 2 to 3 weeks. If you remember the story of the chess board and the grains of rice, we have already a lot of cases in the current square, next square will be 2 times bigger. This can arrive with some possibility everywhere but the question is can it be fastly managed. A successful containment stops the problem at square one.

It is exponentiation growth

http://en.wikipedia.org/wiki/Exponential_function

An exponential fit to the number of cases from mid-July through to mid-September suggests that their number now doubles every 24.3 days (as opposed to every 29 days previously).

http://www.geert.io/exponential-growth-of-ebola.html

Exponential Growth’ in the Ebola Outbreak: What does it mean?

http://sacemaquarterly.com/other-infectious-diseases/exponential-growth-ebola-outbreak-mean.html

The effective reproduction number, Rt, of Ebola virus disease was estimated using country-specific data reported from Guinea, Liberia and Sierra Leone to the World Health Organization from March to August, 2014. Rt for the three countries lies consistently above 1.0 since June 2014. Country-specific Rt for Liberia and Sierra Leone have lied between 1.0 and 2.0.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20894

If reproduction number is below 1 then it will die out by it self. If it is above 1 then it will spread.

Q: recent murder of several relief workers will lead to aid agencies withdrawing from impacted areas

I don’t think that this will stop agencies from responding, but it will definitely impact how and where they work. Staff safety is paramount for all of us, and we need to know that we can do our work without threat of violence. The violence in Guinea is worrisome, and hopefully the authorities there will do what they can to prevent this from happening going forward.

Q: What do you feel is the source of distrust that Ebola is real/dangerous? I’m specifically thinking of the clinic that was attacked and looted.

That feeling of distrust that Ebola is real isn’t as prominent as before because there are so many people getting sick and dying now. The clinic that was attacked and looted in West Point was a politcal issue. It had a lot to do with the fact that there was no communication between higher ups and the local people. There’s a saying that “nothing good ever comes from West Point” so there’s a feeling in West Point that everyone hates them and when they saw Ebola patients from outside of West Point coming in, they thought that they were trying to bring Ebola into their community because they didn’t believe that Ebola was in West Point at that time

The virus already feels uncontrollable, but I think with the help coming that it will change things, but it needs to get here fast enough.

Q: What is the reaction from the community?

Stigma

We know of one woman named Finda whose whole family died but she survived Ebola. Yes, there’s definitely a stigma for survivors. More Than Me wanted to hire Finda for the awareness team but she didn’t feel comfortable being in West Point anymore because of the stigma.

I don’t see anyone working to change this right now. There are dead bodies and sick bodies everywhere. Right now, people and workers are afraid. The main services happening at the moment are that sick people are being brought to holding centers and dead bodies are being picked up to be cremated. All the ETUs and the one holding center are full right now. (ETU = Ebola Treatment Center)

The West Point Commissioner asks US what to do. The community of West Point is pleasantly shocked to see an international person return and me being here gives us extreme credibility. It makes the community feel they’re not alone, that we actually care, that there’s hope. We aren’t just here when the sun is shining, but here through the storms as well.

The community is helping themselves and I’m supporting them. They want rain boots? I get them rain boots. Their t-shirts aren’t working? We get them new ones. That’s what we’re able to do. On top of that, we can help coordinate the awareness workers’ messages, coordinate meetings with partners on the ground, etc.

In West Point, the awareness team is telling families to wash their hands every 15 min if possible, don’t touch bodily fluids of sick people, isolate any sick people you have in the house, and designate one caretaker for the sick. And make sure the caretaker is hydrated and the sick person but the caretaker must use plastic bags to protect themselves from touching them.

We are bringing home nurses to these families with food, and an ebola kit that has everything a family would need to care for a sick person: new bed sheets, vitamin b, rice, bleach bucket, clorox, oral rehydration solution, etc.

The only hospital I’ve been in, that isn’t an ebola place, is Star of the Sea Clinic in West Point. The doctors see Ebola patients coming in nonstop and they have nowhere to send them so it’s definitely getting more risky for the staff there.

Avoiding infection

I’m not touching people, washing my hands constantly, washing my clothes in chlorox. But the main thing I can do is not touch anyone.

West Point and Capital Hill – the two neighborhoods where we’re working – treat us like family. I don’t feel at risk at all being there. The community protects us. I feel like the bond between me and these communities of Liberia is magical right now.

(This next question shows trust isn’t just a problem in Liberia, but everywhere. Someone didn’t believe this was the person she claimed to be.)

Q: For proof, could you please mention this AMA on the MoreThanMe website or tweet about it from @MoreThanMeORG

We’ve tweeted the link and posted on our facebook page: www.facebook.com/morethanmewww.twitter.com/morethanmeorg

Q: What will be most effective?

Definitely donations. All humanitarian responses require funding, and this one is particularly expensive, given the scale and all the inputs required.

We especially want to raise funding to support training and equipment for Liberian first responders. This is something we integrate into all of our work, but it’s particularly important here, as this response requires enormous human resources. Around 90% of our staff here are Liberians, and our first priority is to support them to work safely and effectively. www.firstresponderscampaign.org

Biggest needs are qualified staff, nurses that know how to control infection. Secondly, put pressure on your governments to help. Donations in kind are tricky because the need to respond to specifications. Money for buying those items is better.

We need all kinds of things, but many of them are quite specialized – like doctors and nurses, and specific models of personal protective equipment. The most useful input that the average person with some interest in helping can provide is money to support the operations. Ebola response is very expensive – operating one 70-bed treatment unit can cost up to $1 million/month!

Q: Where to find local accounts?

I don’t know any local Liberians sharing their stories anywhere. Carielle Zoe is a Liberian journalist who’s sharing on her social media, and I’m sharing stories constantly on instagram. (@katiemeyler)

Just today, this morning i prayed and sat with a 15-year old sick boy and he died this afternoon. I went to the courthouse in the afternoon and the people handcuffed were vomiting everywhere and asking me to take them to the hospital.

The burial team, Dr Fallah (mentioned in NYT) and hospital workers, journalists, awareness workers and me are all in the midst of this outbreak, but I’m not sure that any one of them besides journalists are sharing their personal stories.

This is hitting uneducated people who don’t know how to use social media. And for health workers, they are so overwhelmed with the situation that there’s no time to share stories.

Q: I’m worried about some American doctors in Monrovia at Cooper Hospital. I’ve heard rumors that all the other medical facilities closed except EWLA Hospital or possible JFK government hospital. Can you speak to the risks they are facing or give some local knowledge about their neighborhood, etc? I’m realizing I know very little about Morovia (though a reasonable amount about Ebola).

If anyone is interested in reading about their experience, one of the surgeons keeps a diary here.

http://www.ahiglobal.org/main/news/?title=ahi-doctor-heads-to-liberia-to-aid-ebola-crisis–james-appels-personal-log-of-daily-events/

Q: How does it affect you?

It’s hard to see, for sure. I went to pick up a 12-year-old patient on Monday and spoke to him briefly before he boarded the ambulance. An hour later he was dead and the next day I saw his body being carried away for burial.

Q: What is UN/WHO doing?

WHO has staff supporting several ETUs. There are currently six open in Liberia: – Fyoa (MSF) – ELWA III (MSF) – ELWA II (Ministry of Health) – JFK (Ministry of Health with WHO) – Island Clinic (Ministry of Health with WHO) – Bong (IMC)

There is a body in WHO called the GOARN, Global Alert and Response Network. They publish regularly on alerts or updates.

Q: Sean what does your ‘average’ day look like?

Hectic! It usually starts at around 6am and ends at around midnight. In Monrovia, lots of coordination meetings. In Bong, troubleshooting at the ETU, coordinating with government representatives, and sometimes chatting with patients. No two days are ever the same – it’s one of the things I love about my job.

We have a psychosocial team that provides support to our staff and their families.

We provide IV fluids, oral rehydration solution, pain medication, presumptive malaria treatment and symptomatic care.

I think there are lots of untold stories about the very brave health workers here. They’re the real first responders, and they’re continuing to work despite the fear and risk. One of our nurses saw six of her colleagues die from Ebola, but she’s continuing to fight the disease by working with International Medical Corps at the Bong ETU.

We’re seeing quite a few families present together. It’s normal for relatives to care for each other when they’re sick, so this is a common vector for transmission.

Q: Some people there think it is a hoax.

Sadly very true. Ebola is not an hoax. The consequences of negating it are yesterday’s news about killings in Guinea.

Q: On the likely number of cases:

Q: Why don’t they close the airports and put military at all exits of the cities infected? It boggles my mind they haven’t done this yet.

Closing an airport increases risk in bordering countries as people that want to travel, will, but not via official land crossings to the information can not be collected, the temperature can not be taken.

MoreThanMe – latest ebola project report via GlobalGiving

In this together – By Emily Bell – Project Leader

School Nurse Iris handing out care packages

School Nurse Iris handing out care packages

Dear MTM Family,

Thank you for your continued support. Our report this month is going to be a little bit different. As your probably know, there is an Ebola outbreak in West Africa affecting Liberia, Sierra Leone, and Guinea. On July 30th, President Sirleaf recommended that schools close to avoid large gatherings. We decided we needed to close the MTM Academy for the safety of our girls, staff, and community.

On July 31st, the girls and their families came to the school. We gave students care packages that included workbook pages to keep them busy and learning, medicine for fever and bacterial illnesses, Ebola awareness posters, health care referral forms, oral rehydration solutions, chlorine, soap, and rice. All students, parents, and staff also attended an awareness class led by doctors and staff from UNICEF, the IRC, and Ministry of Health. While the school is closed, all expat staff members are being relocated to the US.

To date, we’ve had no reported cases of Ebola related illness in students or staff.

On Friday August 22nd, our founder Katie Meyler arrived in Liberia to help the West Point community, where the majority of our girls live. She has been meeting with community leaders, government officials, health officials, and police to coordinate a faster response to Ebola in West Point. You can follow her journey at http://racingheartblog.tumblr.com/.

Thank you for your continued support. We hope to reopen school as soon as it’s safe for our girls. Until then, we will keep fighting for a better, faster, more organized response to the outbreak, both in West Point and across Liberia. Please direct any questions, comments, or words of support to emilyb@morethanme.org.

In this together,

Emily & the MTM Team

Katie in West Point checking on students

Muslim Clerics in West Africa react to ebola

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Imams in Guinea face Ebola with verses from the Holy Quran

Help Point – Awareness campaigns, punctuated by frequent prayers, fasting, reciting prayers to expedite the redemption of the Ebola virus.. Number of activities and rituals recognized recently Liv imams in Guinea, to lead this interface within the various parties that declared war on the epidemic killer, which is more deadly over the past 40 years in West Africa.

Sheikh Mohamed Lamine Diallo, a representative of the imams at the national anti-Ebola virus in Guinea Conakry, is one of the most prominent religious leaders during the row, declared war on the country’s deadly epidemic, where calls are always speaking to adhere to the teachings of the Koran which calls for Muslims to ensure cleanliness, as the best prevention of the disease. In a statement to Anatolia,

He said “Diallo” established religious body of imams and Christian religious leaders, organizing awareness campaigns, and periodically and systematically, covering different parts of the country.

During these campaigns, we offer a very comprehensive explanation about the prevention methods to be followed, to avoid catching the virus, along with reminders of the role each one in the fight against this disease. ”

For “Diallo”, the hasih epidemic in the country is extremely heavy, and the death of 555 case infected with the virus point to bad situation, leaving the limits of control. The death of 509 people in Sierra Leone and 1,224 in Liberia, not counting the rest of recorded deaths here and there. All of which, according to the Guinean forward, to reflect on the ways of salvation from the “unenviable.” And speaking of, inter alia, the measures taken by the imams in their fight against Ebola, “said Diallo, saying” during sermons in mosques and churches, comes to the epidemic.

Moreover, it is expected that the governing body (against Ebola in Guinea Conakry), over the next few days, consecutive training courses for 600 clerics (imams and Christian clergy), spread over 5 districts of the capital Conakry, as we will, simultaneously, in public places. “Diallo, he said, “this initiative launched by the Secretariat of the Ministry of religious affairs in Guinea, as the virus continues to spread المريع″”, expressing his dismay and regret the large number of deaths due to this disease since the beginning of his appearance in February.

In an effort to console himself with his country, “said Diallo was” everything that happened was God’s will, while Ken lay and believers in testing, the imams to come to help the people to resist.

“For us, this is not about trying to find a religious motivation behind the spread of the Ebola virus in Guinea, but we support the fight against this epidemic and eliminate it.”

A Muslim cleric has opined that the deadly outbreak of the Ebola virus in the country is destined by Allah due to persistent violation of mankind’s covenant to be one another’s keepers in the society.

The Chief Imam of the Salafia Mosque, Sheikh Salah Sheriff, said not only is the Ebola outbreak in the country is the result of Liberia’s broken covenant made to God, he sees the disease, according to the Holy Quran, as what he referred to as “Azabolah”, meaning punishment of God.

Making the disclosure at the Salafia Mosque Tuesday August 26, 2014 in Monrovia, the Muslim cleric described the emergence of the killer disease in the country as a signal of God’s warning to all Liberians, regardless of religion, tribal or political connections.

“I am calling on every citizen to turn a new leaf and begin to be right with the Most High,” the cleric said.

Sheikh Sheriff also attributed the outbreak, occasioned by loss of many lives, to the indulgence of some Liberians in acts of lesbianism and homosexuality, armed robbery, wickedness, cheating, fornication, adultery and disrespect to constituted authorities, all of which are forbidden by God.

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Liberia: ‘God’s Punishment’ – Imam Sheriff Describes Ebola Outbreak

“The belief that God is able to heal the land and have the virus kicked out of the country can be made possible if every citizen can repents from his/her sinful ways and begin to fear God rather than the virus,” the Muslim cleric maintained.

He added that since the outbreak of the Ebola pandemic in the country, many people continue to die not only because of fear but also denial.

Regarding full adherence to Ebola preventive messages and awareness activities being brokered by the national Ebola taskforce, the government and international partners, Sheikh Sheriff maintained that sensitizing worshippers on the danger and prevention of the disease as some measures undertaken by his congregation to prevent the spread of Ebola in the country.

He, however, used the occasion to stress the need for total reconciliation amongst Liberians if the nation is to rise again in the comity of nations.

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Daily Chalk Talks in Monriovia

Another voice that competes with Imams is a local initiative called Daily Talk, which presents local and national stories on a chalkboard outside of a small shack on a central street in Liberia’s capitol of Monrovia. The effort presents news to Liberians where literacy is often a problem. This approach is good because it gets the headlines out there for discussion, and sometimes uses infographics instead of words. But a weakness is that it often reflects the author’s bias and framing of headlines, giving the “village scribe” the too much power to influence public opinion.

I originally re-posted the article in full, but the article’s source sent me a nasty take-down notice, so just click to their version instead (on the title above) to read it.

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.

Runaway Ebola Patient Is Bundled Into Back Of Monrovia Ambulance After He Turned Up Looking For Food At Local Market

Original post by .

A man suffering from Ebola was bundled into the back of an ambulance after he caused mass panic at a market in Liberia when he wandered in looking for food.

The unidentified man walked into a market in the capital Monrovia only to be chased from the area by panicked shoppers. Attempting to make off with loaves of bread, the man is then chased down the road by men wearing yellow protection suits, who eventually catch him and bundle him into the back of a UNICEF vehicle.

Fear: The hungry Ebola patient (red shirt) wandered into the market to get food, causing shoppers to panic

The hungry Ebola patient (red shirt) wandered into the market to get food, causing shoppers to panic.

Threat: The unidentified man walked into a market in the capital Monrovia - which has been badly hit by the worst ever outbreak of the disease - in order to find something to eat

By any means necessary: With locals panicking at the thought of a highly contagious Ebola patient on the loose, the health workers use force to bundle him into the UNICEF vehicle 

With locals panicking at the thought of a highly contagious Ebola patient on the loose, the health workers use force to bundle him into the UNICEF vehicle.

The footage emerged as it was revealed that food in countries hit by the West African Ebola outbreak is becoming increasingly expensive and difficult to find, as farmers are barred from accessing their fields in order to prevent the disease spreading, a UN food agency has warned. Those countries – Guinea, Liberia and Sierra Leone all rely on grain from abroad to feed their people, according to the UN Food and Agriculture Organisation.

Making off with loaves of bread, the man is then chased down the road by men wearing yellow protection suits

Making off with loaves of bread, the man is then chased down the road by men wearing yellowprotection suits.

Taking no chances: The heavily protected health workers eventually catch up with the runaway Ebola patient

The heavily protected health workers eventually catch up with the runaway Ebola patient.

In one market in the Liberian capital of Monrovia, the price of cassava root, a staple in many West African diets, was up 150%. ‘Even prior to the Ebola outbreak, households in some of the affected areas were spending up to 80% of their incomes on food,’ said Vincent Martin, who is co-ordinating the agency’s response to the crisis. ‘Now these latest price spikes are effectively putting food completely out of their reach.’

The UN has said 1.3 million people in Guinea, Liberia and Sierra Leone will need help feeding themselves in coming months. The situation looks likely worsen, FAO said, because restrictions on movement are preventing labourers from accessing farms, and the harvest of rice and corn is set to begin in a few weeks. The World Health Organisation is asking countries to lift border closures because they are preventing supplies from reaching people in desperate need.

Ivory Coast decided last night to keep its borders with Guinea and Liberia closed but said it would open a humanitarian corridor to allow supplies in. The news comes as Ivory Coast’s football association said it will host the country’s African Nations Cup qualifier against Sierra Leone this weekend following a special national security council meeting. The decision, announced in a government statement published in local media today, comes one week after the government said it would not allow the match to go ahead, citing health concerns.

As of August 29, the World Health Organization had confirmed 935 cases of the deadly virus in Sierra Leone – including 380 deaths – though that number is likely to have since risen.

outbreak map

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No escape: The medics cling on to the back of the vehicle as it pulls away to stop the man climbing back out

The medics cling on to the back of the vehicle as it pulls away to stop the man climbing back out.

Anger: Furious Monrovia residents chase the vehicle down the road as a warning to the man not to return

 Furious Monrovia residents chase the vehicle down the road as a warning to the man not to return.