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 Bruce Aylward, the head of Ebola response at the World Health
Organization, said Sierra Leone was well placed to contain the
disease -- its worst outbreak on record -- with infrastructure,
organization and aid.
The problem is that its people have yet to be shocked out of
behavior that is helping the disease to spread, still keeping
infected loved ones close and touching the bodies of the dead.
"Every new place that gets infected goes through that same terrible
learning curve where a lot of people have to die ... before those
behaviors start to change," Aylward told Reuters.
While neighboring Liberia has turned the tide of Ebola, and both
Mali and Nigeria quickly smothered outbreaks, Sierra Leone has more
than 70 percent of cases reported in the past three weeks and more
than half the 18,000 confirmed cases in the nine-month-old outbreak.
The WHO's death toll from outbreak has climbed to 6,583 but the
actual figure is likely to be far higher due to under-reporting of
cases.
The flare-up in Sierra Leone's capital Freetown and the country's
more heavily populated western areas resemble the massive infections
suffered in August by Liberia's capital Monrovia.
That country got its infection rates under control after panic in
quarantined areas led to a riot and the shooting of a young boy by
security forces. Scenes of people dying in the street raised alarm
across the country and prompted a military deployment by the United
States to build treatment centers.
"In Monrovia you had bodies on the streets, you had a riot, you had
someone shot - awareness went through the roof in a very, very short
time as a result," said Aylward.
"You don’t want to see that kind of thing drive public awareness but
it has an impact very, very fast. People changed behaviors in
Monrovia - bang! Like that."
Mali also learned through a shock. Just as it seemed nobody had been
infected by its first Ebola patient in October, another cluster of
deaths sprang up the following month. Aylward said he told Malian
officials that the only way to stop the outbreak was to trace anyone
who may be at risk.
"That’s when the contact tracing... took a jump from around 60-70
percent completion to 98 percent," he said.
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LEARNING CURVE
Denial and ignorance are part of the problem but a weak healthcare
system and logistics also play a part. Officials in Kono - where an
explosion of infections was discovered this week - said the eastern
district of 350,000 inhabitants had only one ambulance and no Ebola
treatment center.
WHO staff are visiting neighboring West African countries to try to
get people to change their ways in case Ebola strikes, but worry
there has been little change in remote border areas, Aylward said.
"The forest area of these three countries has got some really
special and concerning practices, where they share meals with the
corpse, where they sleep with the corpse," he said.
"You know these are high, high risk behaviors."
In Sierra Leone, where as many as 365 Ebola deaths may have been
linked to a single traditional funeral early in the epidemic, Sierra
Leone's Health Minister Abu Bakarr Fofanah said the government was
considering banning some unsafe practices.
He recognized however that it would be difficult to police such a
law.
Fofanah noted that some areas of eastern Sierra Leone that were hit
hardest early in the epidemic -- around the towns of Kenema and
Kailahun -- have seen a massive reduction in case numbers as people
change behavior.
"The areas that are now doing badly are the areas that were affected
last. They are still on the learning curve."
(Editing by Daniel Flynn and Sophie Walker)
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