EBOLA IN SIERRA LEONE:
A History of the 2014 Outbreak Based on National and International Reports
RESPONSES
International Response
United States
Europe
Doctors Without Borders
The United States has responded to the 2014 Ebola outbreak with monetary assistance, military aid and the dispatch of dozens of professional health workers to affected areas. "The United States has concentrated most of its resources, including the military, in Liberia where the epidemic was raging in late summer and the fall." (Washington Post, 2014) However, with the sharp increase in Sierra Leone cases, Barack Obama recognizes that the fight against Ebola is far from over, and is asking congress to pass a $6 billion emergency funding package to combat Ebola in West Africa. (New York Times, 2014) It is unlikely that the United States will send troops to Sierra Leone because Britain has already established a military presence in the country to aid the Ebola fight, but America will continue to provide financial assitance and strive towards producing an effective vaccine.
Many European countries have provided aid to West Africa during the 2014 Ebola outbreak. The European Union, composed of major forces such as the United Kingdom, France and Spain, has contributed over $900 million in aid to West Africa. (European Commission Press Release, 2014) Similarly, the EU has deployed public health experts and humanitarian workers to affected areas, and has established a system of medical evacuation that enables departure of infected individuals from West Africa within 48 hours to designated hospitals in Europe.
Britain, specifically, has promised to construct 6 hospitals across the country with the aim of having 700 beds available for Ebola patients by mid-December. (Channel 4 News, 2014) This is in addition to the 750 British military personel already deployed in the country. (gov.uk, 2014) These medical and military efforts, in combination with US monetary aid, will hopefully serve as a significant force to help contain the raging epidemic in Sierra Leone.
General Tim Radford speaking to his soldiers before their flight to Sierra Leone (Corporal Richard Cave RLC, Crown copyright)
Blueprint for the Ebola treatment center in Port Loko, Sierra Leone (GOAL Aid Agency, 2014)
In an attempt to prevent Ebola from spreading to the United States, President Obama appointed 'Ebola Czar' Ron Klain to head the administration's Ebola response. Although considered an overreaction by many, the United States appears to be taking no chances on the possibility of an Ebola epidemic on US soil. The Department of Health and Human Services announced on December 3 that "35 hospitals in the United States are equipped, staffed and trained to handle Ebola patients." (LA Times, 2014)
Ebola patients treated in the United States:
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Dr. Kent Brantly - August 2, 2014
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Nancy Writebol - August 5, 2014
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Dr. Rick Sacra - September 5, 2014
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Dr. Ian Crozier - September 9, 2014
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Thomas Duncan - September 28, 2014
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Ashoka Mukpo - October 6, 2014
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Nina Pham - October 12, 2014
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Amber Vinson - October 15, 2014
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Dr. Martin Salia - November 15, 2014
6 American Ebola survivors met for the first time the day before Thanksgiving on the 'Today' Show
"It's possible that others will come into contact with Ebola, but it doesn't mean we should stop going, stop praying, stop giving"
- Nancy Writebol
Doctors Without Borders, or Medecins Sans Frontieres, is an international medical and humanitarian relief agency that serves some 70 countries around the globe. In the response to the 2014 Ebola outbreak, it appears that this well known organization has no boundaries, and has played a significant role in the West African epidemic. According to the Wall Street Journal, "Doctors Without Borders is still the most functional outfit in a dysfunctional global health system." (2014) The relief agency currently runs numerous treatment centers in West Africa, and "has treated 60% of all Ebola patients in the West Africa outbreaks as of the end of October." (Wall Street Journal, 2014)
Boots lined up outside of a Doctors Without Borders Ebola clinic in Bo, Sierra Leone
(MSF USA, 2014)
Inside the Ebola Outbreak, 2014
This PBS Documentary goes behind the scenes of a Doctors Without Borders hospital in Sierra Leone during the deadliest Ebola outbreak on record
National Response
The response of the Sierra Leone national government in regards to the 2014 Ebola outbreak has consisted mostly of statistical reports, weekly enforced quarantines and attempted public health campaigns. Constrained mainly due to a lack of financial resources, aid workers sum up the governmental response as "good intentions: poor planning." (New York Times, 2014) The Ministry of Health and Sanitation, the government agency in charge of events such as the current Ebola outbreak, appears to be at a standstill, relying on foreign interventation and international aid in order to curb the epidemic.
Aid officials claim that "government mismanagement and some glaring inefficiencies are costing countless lives." (New York Times, 2014) To add to the chaos, the government recently announced that it had 6,000 'ghost' medical workers on payroll, despite real Ebola healthcare professionals and burial teams not recieving compensation for weeks.
"Good Intentions: Poor Planning"
The Lockdown
On September 19, the Sierra Leone government implemented a three-day, nationwide 'lockdown' in an effort to halt the Ebola outbreak. "Under the plan, no one [was] allowed to leave their homes for three days, allowing volunteers to go door-to-door educating people on the deadly virus." (CNN, 2014) Although the lockdown was declared a "success" by the government due to the finding of nearly 100 bodies, many have criticized the maneuver, claiming "it would destroy trust between patients and doctors" and that "the lockdown has exposed the country's inadequate response capability." (BBC News, 2014) Analyzing Ebola case numbers in the months following, it seems that the September lockdown was little else but a short-term solution to a long-term problem.
The deserted streets of Freetown, Sierra Leone during the mandatory September 'lockdown'
(NBC News, 2014)
Local Response
The response to Ebola on the local level in Sierra Leone has been one of mixed feelings, attitudes and concerns. While many citizens are thankful for international aid, the widespread presence of foreign relief workers has created a sense of mistrust and aid among Sierra Leoneans. For example, United States health workers "can't wear protective gear because they'll frighten the locals," and "they've faced violence, angry crowds, and blockaded roads" (Vox, 2014) from protesters.
More simply, perhaps, is the fact that many Sierra Leoneans are not used to being surrounded by those of a different color on a regular basis. Especially for those residing in rural villages, the sudden presence of foreigners in the country can appear quite shocking. Although a full protective hazmat suit can appear frightening to these villagers that do not have access to that sort of technology, it seems that a misunderstanding of intentions is at the heart of the matter between local Sierra Leoneans and those who want to help.
Fear
Ebola Hazmat Suit
(World News, 2014)
Embarrassment
The fact that Sierra Leone is under an international spotlight during this dismal time in the nation's history is cause for concern among many Sierra Leoneans. The journey of the 2014 Ebola outbreak has been a personal one for many citizens, and having the terrible situation broadcasted internationally creates "a mockery of a national tragedy," according to the Concord Times of Freetown, Sierra Leone. Similarly, having the impoverished nature of the country at the forefront of pictures, documentaries and news articles illustrates Sierra Leone as "a basket case in need of salvation, a land ridden by hunger, poverty, victims of war and disease." (Awareness Times, 2014)
Also, it is easy to compare the health infrastructure of Sierra Leone to Western countries and see the many differences, but having it magnified on an international scale for the world to criticize is a shot to the pride of not only local citizens, but public officials and the government as a whole.
(The Africa Channel, 2014)
(Telesur, 2014)
Distrust
Distrust between Sierra Leoneans and the national and international governments is at an all time high as the Ebola outbreak continues to ravage the country. Feelings of distrust are magnified by both a lack of public health education and an emotional response to the deaths of over 6,000 Sierra Leoneans. According to one citizen, "it isn't Ebola. They want people's blood." (Inside the Ebola Outbreak, 2014) Dr. Sylvia Blyden, a columnist for the largest newspaper in Sierra Leone, The Awareness Times, states, "our Health Ministry dishes out ridiculous statistics on Ebola" and that "international partners are content to watch it go on." (The Awareness Times, 2014) These quotes from Sierra Leone citizens demonstrate the hightened distrust of both the local government as well as those of the West.
Additionally, "one false rumor that is circulating is that health officials might inject suspected Ebola patients with lethal substances," according to Rashid Ansumana, a hospital researcher in Bo, Sierra Leone. (Washington Post, 2014) The portrayal of foreign volunteers as disingenuous is extremely disheartening as they are risking infection of a disease with a 70% mortality rate to serve the population of Sierra Leone. However, this misguided attitude of distrust towards foreign aid workers has been magnified by the lack of public health education in affected areas. This lack of education then pushes blame onto the government, creating a never ending cycle of distrust between the locals, the government and those who just want to help.
Use of military force in the fight against Ebola
(Daily Mail, 2014)
UNICEF, 2014
Cuba
In regards to the current Ebola outbreak, "Cuba leads the world in direct medical support to fight the epidemic." (Milne, 2014) Although the country has a population of just 11 million and per capita income of $6,000, Cuba was quick to respond to the West Africa outbreak and has "sent the largest contingent of dotors and nurses." (Milne, 2014) Currently, 256 Cuban health workers are already on the ground, with another 200 on the way as of December 3, 2014. Cuba has a long history of emergency medical and humanitarian relief according to the World Health Organization, with "more than 50,000 Cuban trained health workers in 66 countries." (World Health Organization, 2014)
