One year on, Ebola still claws at West African nations despite progress

Complacency and traditional beliefs sap fight to eradicate Ebola, warn health officials, as West Africa marks one year anniversary of outbreak that has killed over 10,200 people and infected twice as many.

FREETOWN, SIERRA LEONE (MARCH 20, 2015) (REUTERS) – One year ago, pictures like these would have been unthinkable. Men in space-like suits pulling bodies out of people’s houses, as powerless, grieving relatives are denied the right to bury them.

Ebola, which was first declared in Guinea a year ago on Monday (March 23) but quickly spread to Sierra Leone and Liberia, has killed over 10,200 people and infected twice as many in these three hardest hit countries alone.

But whilst Liberia has been able to almost contain it, Guinea and Sierra Leone are still very much fighting a losing battle.

“The economic development of our country and the lives of our people continue to be threatened by the ongoing presence of Ebola in Sierra Leone. The future of our country and the aspirations of our children are at stake,” said the President of Sierra Leone Ernest Bai Koroma recently.

According to the World Health Organisation (WHO), 4,283 people lost their lives to Ebola in Liberia, whilst Sierra Leone was the next worst affected country with 3,702 dead.

Charles Mambu is an official from Health for All Coalition. He says that these countries were condemned from the very beginning.

“By the time Ebola struck in Kailahun, in Guinea, in Liberia, the government and the citizenry were weak, were not prepared, did not have the resources, do not have the personnel. The number of doctors that we have, only one doctor that was trained in viral disease, so as a result of that, you can see that the extent of spread of the disease from Kailahun district to Kenema district and of course to other parts of the country. It was very fast, because we lacked the technology and the know-how,” Mambu said.

Though the numbers of people infected and dying of Ebola had dropped over the New Year, the disease continued to spike in the coming months in Guinea and Sierra Leone, making a deadline of mid-April to achieving zero cases unrealistic.

Medical staff and Ebola officials talk of a fourth wave happening in Guinea currently, as case numbers are on the increase in certain areas.

Some analysts say that whenever a wave passes and the number of Ebola cases decreases, medical personnel in those countries let their guard down, and mistakes are being made prompting an immediate spike in cases.

As Ebola ravaged through the region, some people found it hard to accept tough rules put in place in order to eradicate the epidemic, including safe burials, and forbidding family members from kissing the bodies of the deceased.

Mambu says communities sometimes acted against medical advice. In Guinea, healthcare personnel would often be attacked, some medics even lost their lives trying to save others.

“We have society men and women who are very powerful within their community, and they have adopted long before this time the fate of that religious person, in fact when he or she dies, that is the time the blessing is actually bestowed upon him or her, and that everybody will want to get that blessing by touching the dead body of that religious person. So this and other factors continue to hamper our fight, our total fight against Ebola in Sierra Leone, because in some of these communities, when these religious people die, they still wash their body, when the society people die, they still wash their body, and they still continue to bury those dead people secretly in the various communities. This is the actual fight we have now,” he said.

As a result, rows and rows of graves, some unmarked, now fill Kingston Cemetery in Freetown.

Cemetery caretaker AbdulRahman Parker says last year had been his hardest year there. Though none of his family died of the disease, he witnessed first hand the raw pain of thousands of people, some who’d seen their families decimated by the disease.

“It was tense, it was tough anyway, you know, coping with family members was a big issue in itself, since when a Sierra Leonean died, bury them, put their body in body bag is very very painful and I feel very very guilty during that burial process here at the Kingtom Cemetery. But by the grace of God we were able to manage situation and put the situation under control,” Parker said.

The number of suspected hidden cases in Guinea has more than doubled since last month, according to the health ministry, prompting fears the epidemic could get out of control into a fourth wave.

Residents in Sierra Leone’s remaining Ebola hotspots will be confined to their houses for three days this week, President Koroma said, as the government tries to snuff out the outbreak.

For the three days, health officials will carry out house-to-house searches to identify the sick in the north and west, where the virus is spreading fastest.

A previous lockdown last September helped identify around 100 cases.

“The campaign will provide an opportunity for communities to be directly involved in the drive to zero cases, to reflect and to pray for the eradication of this disease from our country,” Koroma said.

Preventing unsafe burials remains a top priority in the response to the epidemic, yet there is still resistance to the anti-Ebola effort in some areas where religion and tradition continue to hold more weight than medical science.

On Monday International medical NGO, Medecins Sans Frontieres (MSF) publishes a scathing report titled “Pushed to the Limit and Beyond”.

The report claims that MSF was dismissed as alarmist after it released statements in June, warning that the epidemic was out of control and that it did not have the capacity to respond on its own.

Jerome Mouton, the head of MSF in Guinea, says the root problem remains the same, and until bigger steps are taken to obtain the co-operation of local communities, the disease will continue to swipe through the region.

“The major obstacle that prevents us from going further and putting an end to this epidemic is really Guinea. The resistance of the population there as opposed to the people of Liberia and Sierra Leone who appear to have fully comprehend the existence of this disease and the actions needed to fight it. In Guinea, we are always in a situation where there is denial of the illness or people hiding their patients and refusing to be identified as contact, and it is this (attitude) that prevents us from taking control and really going to the last case,” Mouton said.

Liberia had had a stretch of 21 days without declaring a new case – out of the 42 days the WHO says a country has to be clear of any case to be declared Ebola free. But that changed on Friday (March 20) when a new case was identified.

Porous borders and families strewn across different countries means that Ebola is never far away.

Some analysts say it will take at least till the end of the year for a dramatic decrease in Ebola across the three most affected countries.

In the meantime, people pray their families are spared and that the nation can move on and start rebuilding its future.