Author: Janet Howe

Click here to read a statement from Ernest Bai Koroma, President of Sierra Leone

Click here to read more on the BBC news website

Sierra Leone down to a single chain of Ebola virus transmission

By Saffea Gborie (WHO) Aug 18, 2015, 17:06

Freetown, Sierra Leone – 17 August 2015:  Use of rapid response teams and strong community involvement in finding Ebola virus disease cases and contacts is yielding results in Sierra Leone. An epidemiological week has now passed with no new Ebola cases for the first time since the beginning of the outbreak.

“This is very good news but we have to keep doing this intensively-working with communities to identify potentially new cases early and rapidly stop any Ebola virus transmission” said Dr Anders Nordstrom, WHO Representative in Sierra Leone.

The Ebola response has moved to ‘phase 3’, focusing on tracking each and every chain of Ebola virus transmission and close down the remaining chains as quickly as possible. Sierra Leone is now down to a single chain of transmission, which started in Freetown but sparked a cluster of cases in Tonkolili, in the northern region of the country.

Effectively tracking chains of transmission means finding every person who has been in contact with someone proven to be infected with Ebola, monitoring them closely for symptoms for 21 days and rapidly moving them to a treatment centre if they develop symptom of potential Ebola.

In Tonkolili, a young man, who worked in Freetown but returned to his home village every month to bring food and money to his extended family, died in a hospital where he was being treated for malaria. As is done with all deaths, to ensure no case of Ebola is missed, a swab was taken. It tested positive for Ebola.

Tonkolili had not seen a case of Ebola virus disease for more than 150 days, but the lessons learned during their outbreak in December 2014 had not been forgotten.  The government, WHO and other UN and international partners sent a rapid response team into the district and worked with the village chief and village taskforce to identify and monitor everyone who had been in contact with the young man.

The entire village of Massessehbeh was then put in quarantine for a period of 21 days, as was Masenga Hospital where the young man died. A water supply was established in the village and food was brought in daily. Psychosocial workers and social mobilizers provided information and support, while contact tracers checked everyone daily for symptoms of Ebola.

Two more people, both of them from the young man’s family, developed symptoms and tested positive for Ebola. They were treated at an Ebola Treatment Centre which had been on standby and run by International Medical Corps (IMC).  There they were cared for by a team that included Ebola survivors, who provided much of the physical and psychological care they needed. Both are now recovering.

Last Friday, 595 people ‘graduated’ from quarantine in Tonkolili. This included patients, pregnant women, nurses, doctors and other staff who were released early on Friday morning from the hospital where they had been confined for 21 days. Later the same day, a formal ceremony was held at Massessehbeh during which the President of Sierra Leone formally cut the quarantine tape.

Joyful villagers streamed through the cut quarantine tapes, women linking arms to dance along the road, children beating water bottles in time to the singing and dancing. However, the occasion was not joyful for everyone. 43 people remain quarantined until the end of this week. Another 38 people remain in quarantine in Freetown until the 29th of August.

The Link are thrilled and relieved to hear that a vaccine to end Ebola has finally been found. Trials which have been taking place in Guinea (neighbouring Sierra Leone) have proved to be 100% successful.

We say ‘finally found’ as nearly 4,000 people have died in Sierra Leone (3585 quoted on National Ebola Response Centre, 3951 quoted by the BBC and Centers for Disease Control). 11,284 people have died internationally. However, scientists have heralded the vaccine as remarkable due to the ‘unprecedented speed with which the development of the vaccine and the testing were carried out’ (Guardian newspaper, 31 July 2015).

Yet again, the country will have to rebuild itself. This is desperately sad as following the horrific Civil War, Sierra Leone felt that it was finally getting back on its feet. Although listed as number 183 out of 187 countries on the United Nations ‘Human Development Index 2013’ – a rank which shows how a country compares to the rest of the World in terms of life expectancy/poverty/education etc. – Sierra Leone had expectations of great improvements and was slowly climbing the list.

The 2015 UNDP index is yet to be released. However, we suspect that this upward trend has been brought to a halt. Life expectancy was quoted as being 45.5 years in 2013 – a terribly young age. What will it be in 2015?

One of the biggest catastrophes in Sierra Leone is the number of orphan children that have been created. These children have watched their Mums, Dads, brothers, sisters and community surrounding them die – they must take priority.   Because of poverty levels (72.68% below the poverty line in 2013), taking on care of the children is a huge undertaking. Even though Ebola has hopefully been wiped out, we mustn’t stop helping!

Trials of the vaccine have been funded by the World Health Organisation and a number of countries such as Norway, Canada and Great Britain. The British Government provided £1m of funding and has pledged more to ensure testing continues and is started in Sierra Leone and other countries.

For more information on the vaccine, follow this link to the Guardian newspaper website:

http://www.theguardian.com/world/2015/jul/31/ebola-vaccine-trial-proves-100-successful-in-guinea

A large portion of this consignment was First Aid; very relevant to their current situation.

42 days Counting starts after last discharged case- NERC CEO

Thursday May 14, 2015

NERC Chief Executive Officer of National Ebola Response Centre Retired Major Palo Conteh yesterday said that the Government never knew that the counting to 42 days should start after the last ebola patient is discharged or dies.
“We all at NERC, the President and Ministers thought that we should start counting from the first day we attain zero case, it is only now that WHO is telling us that we have to wait till the last ebola case is discharged or dies. It is news to us.”
The CEO said currently they have four ebola patients in the facilities and that there is a scare at Krootown Town Road where a man ‘escaped’ from Moa Wharf where it is said that his girlfriend had contracted the disease. “Instead of him waiting to be treated, as he had been line-listed, he left and came back to his home, where he was being treated secretly until he reached the wet condition or worse stage.
“When he was picked up, his condition was so bad, he was vomiting blood. His chances of survival is very low. This is what I have been preaching for months now that we must not hide but call 117 when someone is sick.”
Rtd. Maj. Palo Conteh also stressed the point that they are still reviewing the Standard Operating Procedures (SOPs) for burials.
He said in the coming days they will come out with the new SOP. “But for now people should still comply with the laws on burial until they hear from us.”
The NERC CEO averred that last week, it was only two cases that were recorded, which he said is the lowest ever recorded in the country. He urged all to continue to follow the guidelines, so that ebola can be a thing of the past in the country.
CEO Palo Conteh said because the virus is now coming to an end, NERC he said, will relocate soon, as well as downsizing the staff.
He appealed to all the staff that they should understand that the ebola job was temporary and they all should know that it will come to an end someday.
He congratulated Liberia for reaching 42 days and stated that when President Johnson Sirleaf was on BBC, she made it clear that as long as Guinea and Sierra Leone continue to record cases, Liberia will remain at risk.
“Western Area Rural, Port Loko and Koinadugu Districts have also gone 21 days without recording a new case. If this trend continues in those Districts, it means within few weeks they would also reach the 42 days margin. Kambia District and Moa Wharf in the Western Area Urban, which have been the only hotspots for the past three weeks have also gone eight and seven days respectively without recording a new case. I call on them to remain vigilant and even more robust in their drive to keep ebola out of their districts.”
He said there are people in quarantine in the Western Area, Port Loko and Kambia, but they should be optimistic and be mindful that it is possible that some of those in quarantine may become positive. “Which is why it is important that we remain committed to the fight, honest with the case investigators and vigilant in our communities, until we end all quarantine in our communities and discharge or bury the last case of ebola.

With respect to our new project of a Pre-School / Day Care centre, the article in The Guardian [double-click link below] is pertinent. Also see our Projects page