Ebola Rages in Sierra Leone as UN Misses Curbing Targets

By Simeon Bennett and Makiko Kitamura

Photographer: Carl de Souza/AFP via Getty Images

Only 23 percent of cases are being isolated in Liberia, and 40 percent in Sierra Leone, short of a goal set in October to isolate seven-in-ten cases by today. Neither country has enough burial teams to achieve a target of safely burying 70 percent of Ebola-related deaths.

The United Nations has probably missed targets it set for curbing West Africa’s Ebola epidemic, as new treatment centers are being built in Sierra Leone to cope with a surge in infections in that country.
Only 23 percent of cases are being isolated in Liberia, and 40 percent in Sierra Leone, short of a goal set in October to isolate seven-in-ten cases by today. Neither country has enough burial teams to achieve a target of safely burying 70 percent of Ebola-related deaths, according to the World Health Organization. Still, unreliable data make it difficult to know conclusively whether the goals have been met, the Geneva-based WHO said.
While new infections are declining in Liberia and
stable in Guinea, they’re rising in Sierra Leone, particularly in the country’s north and west, including the capital Freetown, according to the WHO. Burial rites in which mourners touch corpses of the dead are continuing to contribute to the spread of Ebola in Sierra Leone, Alpha Kanu, the nation’s information minister, said last week.
“Getting your people who for centuries have been steeped in those cultural practices to abandon those practices overnight is one of the challenges we have been facing,” Kanu said. “The culture of continuing with traditional practices is still very much a challenge. It’s a very touchy-feely African culture.”

Eclipsing Liberia

More than 1,300 people have been infected in Sierra Leone in the past three weeks, and the country’s total number of infections will soon eclipse those in Liberia, the worst-affected country, according to the WHO.
A 120-bed Ebola treatment center in Hastings just east of Freetown is at full capacity and patients are being turned away, said Santigie Sesay, who heads the facility fashioned inside a police training academy.
Instead of hearing instructors shouting commands to police recruits, ambulance sirens bringing in Ebola patients or taking away dead bodies have taken over the Hastings community.
Patients being turned away must make the long journey to other hospitals in Bo, Kenema or Kailahun districts to find empty beds, Sesay said in an interview on Nov. 29. To cope with the rising caseload, a second treatment unit with 270 beds will open this week, he said.

Freetown Treatment

Doctors Without Borders is also building a treatment center in Freetown that will open within the next two weeks, according to Francien Huizing, a spokeswoman for the medical charity in the Sierra Leonean capital.
The rise in cases is still linked to denial, people refusing to take sick people to treatment centers, and unsafe burials, Sesay said.
“We can only see a drop in cases with a change in attitude and acceptance of the health messages,” he said.
About 60 percent of Ebola burials in Sierra Leone are being conducted safely, said Lisa Pattison, a spokeswoman for the Red Cross, which has been leading much of the effort to change burial practices.
The outbreak began on Dec. 6 last year in the remote Guinean village of Meliandou, where a two-year-old boy, Emile Ouamouno, died. It’s since raced through Guinea, Sierra Leone and Liberia, infecting 16,000 people and killing 5,689, making it the worst Ebola outbreak on record. Cases have also been reported in Mali, Nigeria, Senegal, the U.S. and Spain.

Economic Costs

The epidemic may wipe as much as $33 billion from the region’s economy in a worst-case scenario, according to the World Bank, which is mobilizing $1 billion for the response.
In Liberia, only 67 cases were reported in the week to Nov. 23, and the northern district of Lofa has reported no cases for four weeks, the WHO said. Successful community outreach programs to educate people at risk and get them to adopt new burial practices have helped to curb infections, said Dorian Job, deputy emergency program manager for Doctors Without Borders in Geneva.
The charity’s 240-bed ELWA3 treatment center in Monrovia only had 23 patients as of Nov. 17. Still, in some areas community outreach teams lack fuel for their vehicles, preventing them from getting to remote communities, Job said.
“In general, Liberia is better supplied and has more resources than other countries,” he said. “What is important is that we don’t relax the effort. It’s not over.”