Tuesday, September 09, 2014

Ebola: The current situation...

As of the 9th of September 2014, the number of people that have been confirmed to have the Ebola Viral Disease in Sierra Leone is now 1,305. Of those, 893 of the cases are in the two districts of Kenema and Kailahun in the east of the country and 118 of the cases are in the Western Area district, which includes the capital city of Freetown. The rest of the cases are scattered all across the country in all but one district, Koinadugu, the only district with no known Ebola cases.

The situation is getting worse. These numbers are bad enough, but I am certain they are just the tip of the iceberg. The cases mentioned are those who have had laboratory testing, in other words, those who have presented at a health facility. The issue is that many people are not presenting to health facilities. They are either too scared to go for fear of being isolated or contracting the disease, likewise, health care workers are afraid to work for fear of becoming infected. 

All this to say that the numbers reported are likely to be a gross underestimation of the actual situation. There are probably hundreds if not thousands more Ebola cases throughout the country. Many people are sick and dying in their homes, and while suffering they are at the same time spreading the disease to other family members. It is a sad situation.

And now, even if patients want to access healthcare, many health facilities are shut and even the Ebola treatment centres in the country are currently full. This provides a signifiant challenge. The few holding units (isolation centres) in the country that are isolating and testing patients now have nowhere to send their positive patients too. This means that their beds are full and new patients cannot be admitted for isolation and testing. This means that patients are forced to go back into their communities, which leads to further spread of the disease.

The only solution to this problem is to set up more treatment and isolation units across the country, which asks for a strong human resource and logistical commitment from both the government of Sierra Leone, partner organisations and the international community at large. 

There are plans to set up new isolation and treatment centres, but unfortunately it has proven to take weeks, if not months, for these centres to be functional. What will happen to those with Ebola in the meantime and how much more will this virus spread before patients can be properly isolated, tested and treated again? 

I know that both the US and UK governments have agreed to help with setting up (and possibly running?) treatment centres in Liberia and Sierra Leone? But will the proposed 25 and 62 beds respectively be enough? I think the answer is obvious. The international community and the government of Sierra Leone need to scale up their efforts considerably. It is already expected that thousands of additional cases will surface in the next few weeks. What happens next?

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