Breaking the lethal embrace of Ebola

An outbreak of Ebola has claimed almost 400 lives in Liberia, Guinea and Sierra Leone this year, but isolating the sick and good hygiene can stop it dead, writes Alistair Short.

AT THE entrance to the office building, I stop and wash my hands in a bucket of disinfectant and rinse well with hot water. This hand washing station has been established since the outbreak of the Ebola virus here in Liberia, and we ensure everyone coming into the office is using it.

It is one of the small steps we are taking to ensure the virus does not continue to spread and helps to keep our staff at low risk of infection.

The outbreak of Ebola this year has put Liberia into the spotlight of international media for the first time since the end of the civil war 11 years ago. Since February, the disease has claimed almost 400 lives in Liberia, Guinea and Sierra Leone. The crisis is the deadliest and most geographically spread occurrence of the virus since it first emerged in central Africa in 1976.

Ebola is a word that strikes fear into the hearts of people, and the people I meet here in Monrovia are truly terrified of the potential infection. One of the people who died in recent weeks was a health worker. The ripple effect of this was that other health workers abandoned the hospital in panic.

There are reports locally that people in rural areas who usually travel to other villages for basic needs such as food are now refusing to travel and this is resulting in food shortages in a number of villages.

Why is Ebola so thoroughly feared? It’s is a terrifying virus due to the fatality rate (up to 90% in some outbreaks) and due to the gruesome way victims succumb to death. Initial symptoms often include high fever, headaches, muscle pain and intense weakness and later develop into vomiting, diarrhoea, and in some cases internal and external bleeding.

Since the first outbreak almost 40 years ago, the virus has claimed more than 1,600 lives. It is transmitted to people from close contact with bodily fluids, secretions or organs of infected wild animals, often when people eat fruit bats (the natural host of the virus).

There is no known cure for the virus and no vaccine available to prevent infection for either humans or animals.

Investigators have not been able to identify the source of the current outbreak though it appears to have originated in the southeast of Guinea. Here in Liberia we were hopeful last month that the outbreak was ceasing; case numbers were dropping steadily. However, the good news did not last long and infections have been increasingly reported in the last few weeks. There are now four reported cases in an urban slum here in Monrovia, which is very densely populated with little to no hygiene facilities.

In the absence of effective treatment and a vaccine, raising awareness of the risk factors for infection, and teaching people how to protect themselves are the best way to reduce the spread of the virus. Ebola can only pass from person to person by direct contact with bodily fluids, and therefore the spread of the virus is only stoppable by isolation and the careful handling of patients and corpses.

However, controlling the spread of the disease is immensely challenging. Some communities have been resistant to efforts to quarantine sick relatives. Traditional burial rites involving washing bodies are still being followed, despite the risk involved, and those at greatest risk of contracting the virus are family members caring for sick relatives and frontline health workers.

The porous nature of the borders between Liberia, Guinea and Sierra Leone means it is difficult to fully trace the spread of the disease, to carry out thorough contact tracing of infected people and to identify where it is going next.

Closing the borders between the three affected countries would be dangerous, as it could lead to the increase in the use of illegal entry points. Local myths on treating the disease are hard to eradicate; some communities believe a mixture of herbs can cure the virus and are thus less likely to submit suspected cases to clinics.

The Ministry of Health has been doing sterling work in sending clear messages on the facts about the virus and how people can protect themselves. To complement this work, Concern Worldwide have been printing and disseminating thousands of awareness posters and fact sheets. We have also been training health workers in how to protect themselves from the disease, identifying signs of Ebola and in passing on appropriate health messages, as well as establishing hand washing stations where people can properly clean and disinfect their hands, reducing the risks of spreading the virus.

With the virus now claiming lives in 3 countries in West Africa, I believe it is vital that neighbouring countries work together and share information on suspected cases and pool their resources into a coordinated response.

The outbreak can be eventually brought to a halt, but the virus will still remain, unseen and unknown, still present in the fruit bats. In light of this, it is vital that Concern Worldwide and other agencies continue raising and maintaining people’s awareness of Ebola and teaching people how to minimise their risk of infection.

* Alistair Short is country director with Concern Worldwide Liberia.