Sierra Leone is scrambling more health personnel and deploy more equipment to curb the rampant spread of Ebola in Western Area region which currently accounts for half the infections in the country.

Authorities blame dangerous funeral practices, denial, and failure to report cases as some of the factors behind the surge.

In the week ending 14 December, Sierra Leone reported 327 new cases, Guinea had 76 in the same period, while Liberia had eight (but only over two days), according to World Health Organization (WHO) statistics. Sierra Leone has been reporting much higher cases of Ebola compared to its two neighbours.

Thirty-three more ambulances, over 2,000 additional health workers, and support teams are being recruited, and three more treatment centres have opened under the “Operation Western Area Surge” launched by President Ernest Bai Koroma on 17 December to help curb the spread of the virus in the area.

Some 2,500 beds are needed countrywide. Currently there are around 600 beds in Ebola treatment centres. “We can have all the treatment and holding centres, the laboratories and ambulances, but we can only succeed when communities, families and individuals ensure that they do not touch the sick or the dead, and that they report sickness and death to the authorities,” Koroma said.

“Every individual is as much responsible to ensure his survival as the government and its international partners.”

In addition to ramping up control measures in Western Area, the government is also restricting inter-district travel, and church gatherings, over the festive season. In the Western Area, public gatherings in restaurants, clubs and on the beach have been banned.

Lessons from the east

In Sierra Leone’s eastern towns of Kenema and Kailahun where Ebola was first reported in May, the virus has been significantly brought under control. Sidi Yayah Tunis, spokesman for the National Ebola Response Centre (NERC), told IRN they will apply some of the measures used in the east to the Western Area.

“The disease started in Kenema and Kailahun and so what Western Area is dealing with now, Kenema and Kailahun has dealt with before. The only surprising factor is that you would think Western Area should have more awareness or be more cautious than Kenema and Kailahun, considering that they saw what the two districts went through,” Tunis said.

“The house-to-house search in communities to bring cases out reduced the numbers in Kailahun and Kenema, and that is exactly what the Western Area Surge is intended to achieve.”

Tunis pointed out that many districts are reporting zero or just a few cases, with only Western Area and Port Loko seeing higher figures. Port Loko District now has two treatment centres and a laboratory, and measures are also being taken there to get the sick out into isolation and treatment centres, he said.

Tuning a corner?

Unlike Guinea and Liberia, Sierra Leone missed the 1 December target by the UN Mission for Ebola Emergency Response to isolate and treat patients.

On 10 December, WHO reported that there was a flare-up of Ebola in the eastern Kono District near the border with Guinea. It said medical teams buried 87 bodies in 11 days, including a nurse, an ambulance driver, and a janitor drafted in to removing bodies “as they piled up at the only area hospital, ill-equipped to deal with the dangerous pathogen”.

However, during a recent press briefing, Information Minister Alpha Kanu said they were aiming to cut infection rates across the country to single digit figures by the end of the year. He said daily reported cases were averaging about 40 and that, apart from Western Area, the country was making progress in controlling Ebola spread. “Come end of December we should see very, very few cases all over,” he said. “I believe we’ve turned the curve.”

NERC’s Tunis said: “Rapid Response Teams have been established to respond to emerging outbreaks in districts and rural communities and that is what is happening now in Kono.”

President Koroma also said he had held meetings with traditional chiefs and other cultural leaders to urge them to discourage rituals for dead bodies – a practice blamed for the continued spread of Ebola among certain communities.

“We are not yet where we need to be, and there are still huge challenges. But our actions have yielded some progress,” the president said.

IRIN