The Ebola outbreak currently sweeping through West Africa is reaching an unprecedented scale in terms of its geographical spread, the number of cases, and the number of victims. According to the World Health Organization (WHO), there have been 848 cases of Ebola and 518 deaths in Guinea, Sierra Leone, and Liberia since the beginning of the outbreak.
In addition to its work in Guinea, Doctors Without Borders/Médecins Sans Frontières (MSF) has treated more than 70 patients with symptoms resembling those of Ebola in the Kailahun treatment center in eastern Sierra Leone over the past two weeks. Concerned about a possible spike in patients in the coming weeks, MSF teams are augmenting the center’s capabilities as well. “To accommodate growing patient numbers, MSF has expanded the capacity of the treatment center from 32 to 65 beds,” says Anja Wolz, MSF emergency coordinator.
More than 150 national and international staff are now working on the outbreak in Sierra Leone. Because of limited human resources, however, MSF is concentrating its efforts on treating patients and educating communities about the disease.
Beyond medical treatment, controlling the outbreak will require the deployment of large numbers of people to train health care personnel in infection control measures, to follow up with and trace cases and their contacts, to set up an epidemiological surveillance network, and to promote public health messages.
Concerned About “Hidden Cases"
Staff are also doing what they can to find people sick with the virus and those with whom they came into contact. It’s a race against time to stop the spread of the disease. “We’re under massive time pressure," says Wolz. "The longer it takes to find and follow up with people who have come in contact with sick people, the more difficult it will be to control the outbreak."
At the moment, Sierra Leone's Ministry of Health is working with the WHO to reinforce teams for contact tracing. Patients still need to be identified; nearly 40 were reported in just one village in Ngolahun, in the country’s Eastern Province.
“We still have no idea how many villages are affected,” says Wolz. “I’m afraid we’ve only seen the tip of the iceberg.”
Specialized Treatment Facilities
By setting up treatment centers and transit units close to affected villages, MSF can treat patients quickly and reduce the risk of infection in local hospitals and the community. In the transit units in Koindu and Daru, patients showing symptoms are isolated while waiting for the results of their tests.
The Zaire strain of Ebola virus can kill up to 90 percent of patients, but if patients receive treatment at the first signs of the disease, they have a better chance to survive.
Ebola creates fear inside communities, and sick people are often stigmatized. “Families can be driven out of their villages, and sick people can be cast out to die on their own,” says Wolz.
Psychological support is provided to patients and their families. The MSF teams organize participatory health promotion activities with healed patients. To reduce fear, they are also conducting sensitization campaigns to inform people how the virus spreads. As such, they are encouraging people to report suspected cases of haemorrhagic fever, to avoid contact with people sick with the virus, and to avoid touching the dead body of someone who had been ill with Ebola.
In early July 2014, 11 Ministers of Health from the region met with the WHO and international organizations in Ghana to evaluate the situation and take measures to stop the outbreak. MSF asked all parties present to put their promises into immediate action on the ground, to make qualified medical personnel available, to organize training sessions on how to treat Ebola, and to scale up contact tracing and sensitization activities.
MSF also called for leaders and influential people in the affected countries to put out public health messages in affected communities, which will be the only way to reduce the fear and stigma.