BLACK SOCIAL HISTORY
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Ebola virus epidemic in Sierra Leone
Map of Sierra Leone
| |
| Cases contracted in S.L. | 4,759 (as of 2 November 2014)[1] |
|---|---|
| Deaths | 1,070 |
The West African nation of Sierra Leone is currently afflicted by an epidemic of Ebola virus disease (EVD), along with the neighbouring countries of Guinea and Liberia.
On March 18 Guinean health officials announce the outbreak of a mysterious hemorrhagic fever "which strikes like lightning."[2] It was identified as Ebola virus disease and spread to Sierra Leone by May 2014.[3] The disease is thought to have originated when a child in a bat-hunting family contracted the disease in Guinea in December 2013.[4] Consumption of African bushmeat, including rats, bats, and monkeys, is commonplace in Sierra Leone and West Africa in general.[4]
At the time it was discovered, it was thought that Ebola virus is not endemic to Sierra Leone or to the West Africa region and this epidemic represents the first time the virus has been discovered there.[5] However, some samples taken for Lassa fever testing turned out to be Ebola virus disease when re-tested for Ebola in 2014, showing that Ebola had been in Sierra Leone as early as 2006.[6]
History of Ebola in Sierra Leone
| Articles related to the |
| Ebola virus epidemic in West Africa |
|---|
 |
| Overview |
| Ebola virus disease Timeline of the epidemic Responses to the epidemic |
| Affected nations |
| Guinea • Liberia • Sierra Leone • Mali Spain • United States |
| Other outbreaks |
| List of Ebola outbreaks 1976 Zaire outbreak 2014 Congo outbreak |
In 2014 it was discovered that samples of suspected Lassa fever showed evidence of the Zaire strain of Ebola virus in Sierra Leone as early as 2006.[6] Prior to the current Zaire strain outbreak in 2014, Ebola had not really been seen in Sierra Leone, or even in West Africa among humans.[6] It is suspected that fruit bats are natural carriers of disease, native to this region of Africa including Sierra Leone and also a popular food source for both humans and wildlife.[6] The Gola forests in south-east Sierra Leone are a noted source of bushmeat.[7]
Bats are known to be carriers of at least 90 different viruses that can make transition to a human host.[8] However, the virus has different symptoms in humans.[8] It takes one to ten viruses to infect a human but there can be millions in a drop of blood from someone very sick from the disease.[9][10] Transmission is believed to be by contact with the blood and body fluids of those infected with the virus, as well as by handling raw bushmeat such as bats and monkeys, which are important sources of protein in West Africa. Infectious body fluids include blood, sweat, semen, breast milk, saliva, tears, feces, urine, vaginal secretions, vomit, and diarrhea.[11]
Even after a successful recovery from an Ebola infection, semen may contain the virus for at least two months.[12] Breast milk may contain the virus for two weeks after recovery, and transmission of the disease to a consumer of the breast milk may be possible.[13] By October 2014 it was suspected that handling a piece of contaminated paper may be enough to contract the disease.[14] Contamination on paper makes it harder to keep records in Ebola clinics, as data about patients written on paper that gets written down in a "hot" zone is hard to pass to a "safe" zone, because if there is any contamination it may bring Ebola into that area.[14] (see also Fomites)
One aspect of Sierra Leone that is alleged to have aided the disease, is the strong desire of many to have very involved funeral practices.[15] For example, for the Kissi people who inhabit part of Sierra Leone, it is important to bury the bodies of the dead near them.[15]Funeral practices include rubbing the corpses down with oil, dressing them in fine clothes, then having those at the funeral hug and kiss the dead body.[15] This may aid the transmission of Ebola, because those that die from Ebola disease are thought to have high concentrations of the virus in their body, even after they have died.[15]
For the 2001 outbreak of Sudan virus in Uganda, attending a funeral of an Ebola victim was rated by the CDC as one of the top three risk factors for contracting Ebola, along with contact with a family member with Ebola or providing medical care to someone with a case of Ebola virus disease.[16] The main start of the outbreak in Sierra Leone was linked to a single funeral in which the WHO estimates as many as 365 died from Ebola disease after getting the disease at the funeral.[17]
Bushmeat has also been implicated in spreading Ebola disease, either by handling the raw meat or through droppings from the animals.[18] It is the raw blood and meat that is thought to be more dangerous, so it is those that hunt and butcher the raw meat that are more at risk as opposed to cooked meat sold at market.[19] Health care workers in Sierra Leone have been warned not to go to markets.[20]
A relative of Ebola, Marburg virus, was discovered in 1967 when there was an outbreak of the disease in a German laboratory that was trying to develop vaccines. They contracted the disease from imported monkeys, but the disease was further traced to fruit bats. As recently as 2008 a European tourist died from Marburg after visiting a bat cave in Africa.[21] Ebola, Marburg, and Lassa bleeding fevers are known to be transmitted through contact with infected animal feces and/or urine.[22]
Spring 2014: Early cases
In late March there were suspected but not confirmed cases in Sierra Leone.[23] The government announced on 31 March 2014 that there were no cases in Sierra Leone.[24]
The epidemic is thought to have started in late May when 14 people returned from a funeral of a traditional healer, who had been trying to cure others with Ebola in Guinea.[3] The first person reported infected was atribal healer. She had treated an infected person(s) and died on 26 May. According to tribal tradition, her body was washed for burial and this appears to have led to infections in women from neighboring towns.[25]
The corpses are highly contagious immediately after death, so precautions such as hazmat suits are needed.[26] In this region the practice of kissing and touching the dead has been implicated in helping to spread Ebola.[27] However, two U.S. doctors who "followed all CDC and WHO protocols to the letter" still managed to contract the disease and it is not clear how they got the disease.[28]
By 27 May 2014 it was reported 5 people died from the Ebola virus and there were 16 new cases of the disease.[29][30] Between 27 May 2014 and 30 May the number of confirmed, probable, or suspected cases of Ebola went from 16 to 50.[31] By 9 June, the number cases had risen to 42 known and 113 being tested, with a total of 16 known to have died from the disease by that time.[32]
The disease spread rapidly in the area, and the local government hospital was overwhelmed.[17] At that hospital 12 nurses died despite having the world's only Lassa fever isolation ward, according to the U.N.[17] The hospital proved instrumental early on, detecting the first case in the country and supporting the release of a research paper on Ebola.[33] However, the growing number of cases there led to infection and loss of Sierra Leone's hemorrhagic fever expert, Doctor Khan, and the normal functioning of the hospital was disrupted because of the danger of getting infected by the disease.[33]
Summer 2014: Continued growth, Khan dies
On 12 June the country declared a state of emergency in the Kailahun District, where it announced the closure of schools, cinemas, and nightlife places; the district borders both Guinea and Liberia, and all vehicles would be subject to screening at checkpoints.[34][35] The government declared on 11 June that its country's borders would be closed to Guinea and Liberia; but many local people cross the borders on unofficial routes which are difficult for authorities to control.[36][37] Seasonal rains that fall between June and August interfered with the fight against Ebola, and in some cases caused flooding in Sierra Leone.[38]
By July 11, 2014 the first case was reported in the capital of Sierra Leone, Freetown, however the person had traveled to the capital from another area of the country.[39] By this time there were over 300 confirmed cases and 99 were confirmed to have died from Ebola.[39] There was another case before the end of the month.[40]
On 29 July, well-known physician Sheik Umar Khan, Sierra Leone's only expert on hemorrhagic fever, died after contacting Ebola at his clinic in Kenema. Khan had long worked with Lassa fever, a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's President, Ernest Bai Koroma, celebrated Khan as a "national hero".[25]
On 30 July, it declared a state of emergency and deployed troops to quarantine hot spots.[41]
In August, awareness campaigns in Freetown, Sierra Leone's capital, were delivered over the radio and through loudspeakers.[42] Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak.[43] Also in early August Sierra Leone cancelled league football (soccer) matches.[44]
September 2014: Exponential growth, quarantines
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Within 2 days of 12 September 2014, there were 20 lab-confirmed cases discovered in Freetown, Sierra Leone.[45]One issue was that residents were leaving dead bodies in the street.[45] By 6 September 2014 there were 60 cases of Ebola in Freetown, out of about 1100 nationwide at this time.[46] However, not everyone was bringing cases to doctors, and they were not always being treated.[46] One doctor said the Freetown health system was not functioning, and during this time, respected Freetown Doctor Olivette Buck fell ill and died from Ebola by 14 September 2014.[46][47] The population of Freetown in 2011 was 941,000.[48]
By 18 September 2014 teams of people that bury the dead were struggling to keep up, as 20-30 bodies needed to be buried each day.[49] The teams drive on motor-bikes to collect samples from corpses to see if they died from Ebola.[49] Freetown, Sierra Leone has one laboratory that can do Ebola testing.[49]
WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.[50]Experts pushed for a greater response at this time noting that it may destroy Sierra Leone and Liberia.[51] At this time it was estimated that if it spreads through both Liberia and Sierra Leone up to 5 million could be killed.[52] (The population of Liberia is about 4.3 million and Sierra Leone is about 6.1 million.)
In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams.[53] The campaign was called the Ouse to Ouse Tock in Krio language.[54] There was concern the 72 hour lock-down could backfire.[55]
On 22 September, Stephen Gaojia said that the three day lock down has obtained its objective and will not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases have been uncovered, but the exact figures will only be known on Thursday as the health ministry is still awaiting reports from remote locations.[56]One incident during the lock-down, was when a burial team was attacked.[57]
On 24 September, President Ernest Bai Koroma added three more districts under "isolation," in an effort to contain the spread. The districts include Port Loko, Bombali, and Moyamba. In the capital, Freetown, all homes with identified cases will be quarantined. This brings the total areas under isolation to 5, including the outbreak "hot spots" Kenema and Kailahun which are already in isolation. Only deliveries and essential services will be allowed in and out. A sharp rise in cases in these areas was also noted by WHO.[58]
As of late September about 2 million people are in areas of restricted travel,[59] which include Kailahun, Kenema, Bombali, Tonkolili, and Port Loko Districts.[60]
The number of cases seemed to be doubling every 20 days, which led to the estimate that by January 2015 the number of cases in Liberia and Sierra Leone could grow to 1.4 million.[61]
On 25 September there were 1940 cases and 587 deaths officially, however, many acknowledged under-reporting and there was an increasing number of cases in Freetown (the capital of Sierra Leone).[62]
WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.[50] There have been reports that political interference and administrative incompetence have hindered the flow of medical supplies into the country.[63]
October 2014: Responders overwhelmed
By 2 October 2014, it was estimated 5 people an hour were being infected with the Ebola virus in Sierra Leone.[64] By this time it was estimated the number of infected has been doubling every 20 days.[65] On 4 October, Sierra Leone recorded 121 fatalities, the largest number in a single day.[66] On 8 October, Sierra Leone burial crews went on strike.[67] On 12 October, it was reported that the U.K. would begin providing military support to Sierra Leone.[68]
In October it was noted hospitals are running out of supplies in Sierra Leone.[69] There have been reports that political interference and administrative incompetence have hindered the flow of medical supplies into the country.[70] In the week prior to 2 October there were 765 new cases, and Ebola was spreading rapidly.[71] At the start of October there were nearly 2200 laboratory confirmed cases of Ebola and over 600 had passed away from it.[72] The epidemic also claimed the life of 4 doctors and at least 60 nurses by the end of September 2014.[73] Sierra Leone limits its reported deaths to laboratory confirmed cases in facilities, so the actual number of losses is known to be higher.[14]
Sierra Leone was considering making reduced care clinics, to stop those sick with Ebola from getting their families sick with the disease and to provide something in between home-care and the full-care clinics.[74]These "isolation centers" would provide an alternative to the overwhelmed clinics.[74] The problem the country is facing is 726 new Ebola cases but less than 330 beds available.[75]
More than 160 additional medical personnel from Cuba arrived in early October, building on about 60 that had been there since September.[76] At that time there were about 327 beds for patients in Sierra Leone.[77]
Canada announced it is sending a 2nd mobile lab and more staff to Sierra Leone on 4 October 2014.[78]
There were reports of drunken grave-diggers making graves for Ebola patients too shallow, and as a result wildlife comes and digs up and eats at the corpses.[79] In addition, in some cases bodies are not buried for days, because no one comes to collect them.[80] One problem is that it has been hard to care for local health care workers, and there is not enough money to evacuate them.[81] Meanwhile other diseases like malaria, pneumonia, and diarrhea are not being treated properly because the health system is trying to deal with Ebola patients.[82]
On 7 October 2014 Canada sent a C-130 loaded with 128,000 face shields to Freetown.[83]
In early October 2014, a burial team leader said there were piles of corpses south of Freetown.[84] On October 9 the International Charter on Space and Major Disasters was activated on Sierra Leone's behalf, the first time that its charitably repurposed satellite imaging assets have been deployed in an epidemiological role.[85][86] On 14 October 2014, 800 Sierra Leone peacekeepers due to relieve a contingent deployed in Somalia, were placed under quarantine when one of the soldiers tested positive for Ebola.[87]
The last district in Sierra Leone untouched by the Ebola virus has declared Ebola cases. According to Abdul Sesay, a local health official, 15 suspected deaths with 2 confirmed cases of the deadly disease were reported on 16 October in the village of Fakonya. The village is 60 miles from the town of Kabala in the center of mountainous region of the Koinadugu district. This was the last district free from the virus in Sierra Leone. All of the districts in this country have now confirmed cases of Ebola.[88]
In late October 2014, the United Kingdom sent one of their hospital ships, the Royal Navy's Argus, to help Sierra Leone.[89] By late October Sierra Leone was experiencing more than twenty deaths a day from Ebola.[90] In October 2014, officials reported that very few pregnant women were surviving Ebola disease.[91] In previous outbreaks pregnant women were noted to have a higher rate of death with Ebola.[92]
Officials struggled to maintain order in one town after a medical team trying to take a blood sample from a corpse were blocked by an angry machete wielding mob. They allegedly believed the person had died from high-blood pressure and did not want the body being tested for Ebola. When security forces tried to defend the medical team, a fatal riot ensued leaving two dead. The town was placed on a 24 hour curfew and authorities tried to calm the situation down.[93] Despite this several buildings were attacked.[94]
On 30 October the ship Argus arrived in Sierra Leone.[95] It carried 32 off-road vehicles to support Ebola treatment units.[96] The ship also carried three transport helicopters to support operations against the epidemic.[97] By the end of October 2014 there were over 5200 laboratory confirmed cases of Ebola virus disease in Sierra Leone.[98]
On 31 October 2014 an ambulance driver in Bo District died of Ebola. His ambulance picked up Ebola patients (or suspected Ebola cases) and took them to treatment centers.[100]
November 2014: Continuing struggle
On 1 November 2014 the United Kingdom announced plans to build three more Ebola laboratories in Sierra Leone. The labs help determine if a patient has the Ebola disease. At this time it can take even 5 days to test a sample because of the volume of samples that need to be tested.[101]
On 2 November 2014 a person employed by the U.N. infected with Ebola virus disease was evacuated from Sierra Leone to France for treatment. France previously treated a French nurse evacuated from Liberia in September 2014.[102]
The Neini Chiefdom in Koinadugu District was subject to isolation after Ebola cases. [103]
Healthcare capacity
On 26 August, the WHO shut down one of two laboratories after a health worker became infected. The laboratory was situated in theKailahun district, one of the worst-affected areas. It was thought by some that this move would disrupt efforts to increase the global response to the outbreak of the disease in the district.[104]
"It's a temporary measure to take care of the welfare of our remaining workers," WHO spokesperson Christy Feig announced. He did not specify how long the closure would last, but said they would return after an assessment of the situation by the WHO. The medical worker, one of the first WHO staff infected by the Ebola Virus, was treated at a hospital in Kenema and then evacuated to Germany.[104][105] By 4 October 2014, it was announced he has recovered and left Germany.[106]
As the Ebola epidemic grew it damaged the health care infrastructure, leading to increased deaths from other health issues including malaria, diarrhoea, and pneumonia because they were not being treated.[107]
The WHO estimated on 21 September that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds.[50]
Death of health workers
Sierra Leone lost three of its top doctors by the end of August, because they died from Ebola.[109] A fourth doctor became ill with Ebola in September and died that month.[110]
By 23 September 2014 about 61 health workers had died out of 91 known to have been infected with Ebola in Sierra Leone.[111]
Dr. Olivette Buck was a Sierra Leone doctor who worked in Freetown, who tested positive for Ebola on 9 September 2014 and died on 14 September 2014.[47] Her staff thought she got exposed in August and eventually went to Lumley Hospital on 1 September 2014 with a fever, thinking it was malaria.[47] After a few more days of sickness she was admitted to Connaught Hospital.[47]
On 19 October the WHO reported 129 cases with 95 deaths of healthcare workers (125 / 91 confirmed).[114]
Another Sierra Leone Doctor died from Ebola in early November 2014.[115]
Evacuations
Since the beginning of the outbreak in Sierra Leone in late May 2014, several people have been evacuated. An increasing lack of hospital beds, medical equipment, and health care personnel makes treatment difficult.
On 24 August William Pooley, a British nurse, was evacuated from Sierra Leone. He was released on September 3, 2014.[116][117] In October 2014 he announced he would return to Sierra Leone.[118]
On 21 September 2014 Spain evacuated a Catholic priest who had contracted Ebola while working in Sierra Leone with Hospital Order of San Juan de Dios.[119] He died on the 25th September in Madrid.[120] On 6 October 2014 a nurse who treated the priest tested positive for Ebola.[121] By 20 October 2014 the nurse seemed to have recovered after many days battling the disease in the hospital, with tests coming back negative.[122] The Ebola virus can remain in urine, breast milk, vaginal secretions, and feces for roughly 15-30 days after recovery depending on the person and fluid type.[123] (see also Convalescence)
A doctor from Senegal contracted Ebola while working in Sierra Leone for the WHO, and was evacuated to Germany at the end of August 2014.[124] By 4 October 2014, it was announced he has recovered and returned to Senegal.[106]
In late September, a doctor working for an International Aid organization in Sierra Leone, was evacuated to Switzerland after potentially being exposed. He later tested negative for the disease.[125]
In late September 2014, an American doctor working in Sierra Leone was evacuated to Maryland, USA, after being exposed to Ebola.[126] "Just because someone is exposed to the deadly virus, it doesn’t necessarily mean they are infected”, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH.[126] He was evacuated after a needle sticking accident and even developed a fever, but he was determined not to have Ebola and was released the first week in October 2014. After being discharged he remained at home under medical observation, checking his temperature twice a day for 21 days.[127]
In early October, a Ugandan doctor who contracted Ebola while working in Sierra Leone was evacuated for treatment to Frankfurt, Germany.[128] The doctor was working at Lakaa Hospital and flown out from Lungi Airport.[129]
On 6 October 2014, a female Norwegian MSF worker tested positive for Ebola virus and was subsequently evacuated to Norway.[130] Norwegian authorities reported that they had been granted a dose of the experimental biopharmaceutical drug ZMAb, a variant of ZMapp.[131][132][133] ZMapp has previously been used on 3 Liberian health workers, of which 2 survived.[134] It was also used on 4 evacuated westerners, of which 3 survived.[135][136][137][138][139][140] (see List of Ebola patients)
A U.N. employee was evacuated to France in early November 2014 after contracting Ebola.[141]
Confounding factors
Sierra Leonean government intransigence
On October 5, the New York Times reported that a shipping container full of protective gowns, gloves, stretchers, mattresses and other medical supplies had been allowed to sit unopened on the docks in Freetown, Sierra Leone, since August 9.[142]The $140,000 worth of equipment included 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks and other items, and were donated by individuals and institutions in the United States.[142]
The shipment was organised by Mr Chernoh Alpha Bah, a Sierra Leonean opposition politician, who comes from Sierra Leonean President Ernest Bai Koroma’s hometown, Makeni.[142] The New York Times reported that political tensions may have contributed to the government delay in clearing the shipping container, to prevent the political opposition from trumpeting the donations.[142]
Government officials stated that the shipping container could not be cleared through customs, as proper procedures had not been followed.[142] The Sierra Leonean government refused to pay the shipping fee of $6,500.[142] New York Times noted that the government had already received well over $40 million in cash from international donors to fight Ebola.[142] The New York Times noted that in the 2 months that the shipping container remained on the docks in Freetown, health workers in Sierra Leone endured severe shortages of protective supplies, with some nurses having to wear street clothes.[142]
Local conspiracy theories
- “The Ebola outbreak was sparked by a bewitched aircraft that crashed in a remote part of Sierra Leone, casting a spell over three West African countries -- but a heavily alcoholic drink called bitter Kola can cure the virus.”[143]
- “Some members of the community thought it was a bad spirit, a devil or poisoning.”[144]
- At the beginning of the outbreak, many did not believe that the disease existed. “I thought it was a lie (invented) to collect money because at that moment I hadn´t seen people affected in my community.”[144]
Community violence
On October 21, there was Ebola related violence and rioting in the eastern town of Koidu, with police imposing a curfew.[145] Local youth fired at police with shotguns after a former youth leader refused health authorities permission to take her relative for an Ebola test.[145] Several buildings were attacked and youth gangs roamed the streets shouting "No more Ebola!"[146]
A local leader reported seeing two bodies with gunshot wounds in the aftermath. Police denied that anyone had been killed.[145] Doctors reported two dead.[146] The local district medical officer said he had been forced to abandon the local hospital because of the rioting.[145]
Effects
Travel restrictions
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There are various restrictions and quarantines within Sierra Leone, and a state of emergency was declared on July 31, 2014.[147] Countries at higher risk for Ebola in Africa include Benin, Burkina Faso, Côte d’Ivoire, Guinea-Bissau, Mali, and Senegal.[148]
- In April Gambia banned air travel from several West African countries including Sierra Leone.[149]
- By June 11, 2014 Sierra Leone closed its border with Liberia and Guinea.[35]
- In July airlines of Nigeria and Togo cancelled flights to Freetown.[147]
- On August 1, 2014 Ghana banned air travel from several Ebola impacted countries including Sierra Leone.[150]
- On August 8, 2014 Zambia banned travelers from Sierra Leone and Ebola-affected countries and also banned Zambians from going to those places.[151]
- On August 10, 2014 Mauritania blocked entry of citizens of Sierra Leone.[152]
- On August 11, 2014 Ivory Coast blocked travel from Sierra Leone, Liberia, and Guinea.[153] The restriction was lifted on 26 September 2014.[154]
- On August 21, 2014 South Africa banned travelers from Sierra Leone, Liberia, and Guinea, but its own citizens were allowed to return from these places.[155]
- On August 22 a Kenyan airline put temporary restrictions Sierra Leone, saying the Ebola outbreak was underestimated.[156]
- On August 22 Senegal blocked air travel to Sierra Leone, Liberia, and Guinea.[157]
- In September 2014 bans on the Sierra Leone hosting federation football (soccer) games continued.[158]
- In October 2014 Trinidad and Tobago banned travelers from the Ebola-stricken West African countries, including Sierra Leone.[159]
- In October 2014 Jamaica, Colombia, Guyana and Saint Lucia banned travelers from Sierra Leone and other affected West African countries.[160]
- In mid October 2014 Saint Vincent and the Grenadines banned Sierra Leone nationals and those from some other West African nations.[161]
- In late October Panama banned anyone coming from, or had been in Sierra Leone, Liberia, or Guinea in the previous 21 days.[162]
- By 21 October the Dominican Republic banned foreigners who had been to Sierra Leone or other Ebola effected nations in the previous 30 days.[163]
Additional effects
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The outbreak was noted for increasing hand washing stations, and reducing the prevalence of physical greetings such as hand-shakes between members of society.[164]
In June 2014 all schools were closed because of the spread of Ebola.[165]
In August 2014 the S.L. Health Minister was removed from that office.[166] (see Cabinet of Sierra Leone) In October 2014 the Defense Minister was placed in charge of the anti-Ebola efforts.[167] The President at this time was Ernest Bai Koroma.[167]
On October 13, the UN's International Fund for Agricultural Development stated up to 40% of farms had been abandoned in the worst Ebola-hit areas of Sierra Leone.[168]
In October 2014 Sierra Leone launched a school by radio program, that will be transmitted on 41 of the local radio stations as well as on the only local TV station.[169] There will be a variety of subjects on the 6 day a week, 4 hour shows. Education Minister Minkailu Bah raised concerns on the difficulty of reaching many of the school children with a 25% radio ownership and less than 2% TV. However schools are not expected to open until early 2015.[170]
September through October is the malaria season, which may complicate efforts to treat Ebola.[171] For example, one Freetown doctor did not immediately quarantine herself because she thought she had malaria not Ebola.[47] The doctor was eventually diagnosed with Ebola and died in September 2014.[47]
Local works derived from the Ebola crisis
- A Sierra Leone DJ, Amara Bangura, shares knowledge about Ebola in his weekly show which is transmitted on 35 stations in Sierra Leone. He takes selected questions from the text messages sent in and gets answers from health experts and government officials.[172] An example of a radio station in Sierra Leone is Capital Radio Sierra Leone.
- "White Ebola", a political song by Mr. Monrovia, AG Da Profit and Daddy Cool, centered on the general mistrust of foreigners.[173]
- "Ebola in Town", a dance tune by a group of West African rappers, D-12, Shadow and Kuzzy Of 2 Kings warns people of the dangers of the Ebola virus and explaining how to react, became popular in Guinea and Liberia during the first quarter of 2014.[174][175] A dance was developed in which no body contact was required, a rare occurrence in African dance.[176] Some health care workers from the IFRC had concerns that the Ebola In Town song's warning "don't touch your friend" may worsen the stigma.[176][177]
- In August 2014, George Weah and Ghanaian musician Sidney produced a song to raise awareness about Ebola.[178] All proceeds from the track been donated to the Liberian Health Ministry.[179]
- There are a number of Ebola-themed jokes circulating in West Africa to spread awareness.[180]
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