An NGO said containing the West Africa Ebola epidemic will require overcoming fear and stigma surrounding the disease. ActionAid says the high death rate has caused a lack of faith in the medical system. The group is helping to contain the outbreak in Sierra Leone.
The World Health Organization says there have been more than 470 confirmed cases of Ebola in Sierra Leone. There are several hundred more suspected cases. More than 230 people have died.
ActionAid Country Director Mohamed Silah says the major challenge facing Sierra Leone, Guinea and Liberia is a poor health infrastructure. He says the countries are simply not well-equipped to handle the crisis because of a lack of investment in health.
Silah said those countries need to act to change that.
“First it has to do with necessary training for the staff – equipping the staff with the basic equipment that they need to actually carry out their work. Issues as simple as an ambulance are a challenge for major hospitals. If you have a suspected case there are very limited ambulances around to collect the sick people and evacuate them.”
He said many community health centers lack access to electricity. That means no refrigeration to safely store vaccines or drugs that are susceptible to heat.
Another major problem is fear. And fear of Ebola is widespread among the population. The ActionAid country director said many people actually deny the existence of the disease and attribute the sickness and death to some other cause.
Also, the message that was sent out after the Ebola outbreak was confirmed was that it had no cure. When families did bring their sick relatives to the hospital, the patients were immediately placed in quarantine and the families lost contact with them.
"That lack of communication – that lack of clarity – brought about the mistrust. People saw the hospitals now as a death zone. What happens in the isolation enters was not very, very clear to the general public,” he said.
There have been several incidents in Sierra Leone where families removed infected people from hospitals. Those incidents, Silah said, not only indicate the lack of information families had about the disease, but the lack of security at the health facilities.
But what message can be sent when a disease is so often fatal? Silah said it has to do with educating communities. ActionAid staff and others are going door to door in Sierra Leone doing just that, explaining prevention methods, signs and symptoms and the importance of taking people to the hospital.
“Because we have a long time presence in the communities, they trust us. They trust the information that we give them.”
Local and traditional leaders play a big role in those education efforts.
Silah also said there’s a lack of testing centers. For example, there are just two in eastern Sierra Leone. One is run by the Ministry of Health and the other by Doctors Without Borders. Some people may have to travel hundreds of kilometers to reach them and then wait two or three days for the results. It was during that waiting period that families removed patients from health facilities.
One thing being done to raise hope among the population is to talk about the people who became infected and survived. ActionAid, the Ministry of Health and many volunteers are sending the message that medical care gives people a chance of overcoming the disease. And they point to the nearly 130 infected people who have, so far. And those survivors are now helping to educate the population through media campaigns.
“We are gaining the confidence of the people. And what you can even see from the government figures if that the number of people who are reporting to the health centers is actually increasing,” he said.
Silah is calling for greater international support for Sierra Leone to increase the number of Ebola rapid testing centers. He says this would go a long way toward controlling the outbreak.