Fear and loathing: Sierra Leone goes into lockdown
AS the early-morning mist lifts from this hillside in Kenema, a silent team of police and army personnel surround a small compound of houses along Sinnah Street.
Most of the team are armed with semi-automatic weapons. Some have gloves and facemasks.
None of these items are particularly effective against what health authorities fear is inside the houses.
“There was a death here and it has been confirmed as Ebola, and there are six other possible cases already in isolation wards,” Insp Desmond Vandy tells the Irish Independent.
“This area is to be quarantined. The families affected are to be isolated here for 21 days.”
There are six families affected by the quarantine. All have young children. None of these people is showing any symptoms – but it can be up to 21 days before an infected person starts to exhibit signs, usually in the form of a fever.
“If, say, on the 10th day, one person begins to exhibit symptoms, then the 21-day quarantine begins again,” Patrick Senassie, a local programme manager for aid agency Goal, explains.
“I know of one place where the isolation lasted 45 days.”
Goal is training the police and other groups here on best practice when dealing with people suspected of, or carrying, the highly-contagious and often-deadly disease.
Ebola spreads only in close contact. There is no cure, and no vaccine.
At least 15 homes, compounds or streets in Kenema are currently quarantined, but the quarantine on Fudia Sesay’s home was recently lifted.
“The day they came to quarantine my house and bring me to hospital was the day my daughter passed away,” the 49-year-old says, tears willing up. “The pain was not easy for me.”
Her daughter Sera Kemere was a nurse at Kenema Government Hospital, and was five months pregnant.
“She was tested and they said malaria. I brought her some pap (a local porridge) in hospital and we shared that. I think that’s how I got it,” Fudia says.
She describes in detail her daughter’s death and her own battle against the virus which generally brings huge suffering to the infected and leaves little dignity.
But she was one of the lucky ones, relatively-speaking, surviving although she also lost the sight in her left eye.
The epidemic in West Africa - the worst since the disease was discovered in 1976 - has killed more than 2,400 people in Guinea, Sierra Leone, Liberia, and Nigeria and has also spread to Senegal.
Up to 20,000 could be affected, with the United Nations estimating that €800m is needed to fight a health crisis “unparalleled in modern times”.
The first-ever case of Ebola in Sierra Leone was recorded in the remote Kailahun region, near the border with Guinea and Liberia, in May, and there have been more than 1,300 confirmed cases since.
However, it is thought that there have been many more as people – fearful that diagnosis means certain death in an isolation ward – are unwilling to identify themselves as having symptoms.
In an effort to combat that, the entire country is in effective quarantine this weekend.
It means every Sierra Leonean is quarantined inside their homes, stopped from leaving from late on Thursday until after the ‘lockdown’ ends tomorrow.
Meanwhile, volunteers are due to visit every household and “likely Ebola cases will be identified or dead bodies will be referred to contact tracing, referral or burial teams”, according to a leading government health official.
The three-day lockdown has been widely criticised – not least because of the 21-day incubation period.
It will also impact on the livelihoods and earning potential of a population that often lives hand-to-mouth, adding to the worry that exacerbated poverty will cause more deaths than the virus.
And Medicines sans Frontiers (MSF) said door-to-door screening requires a high-level of expertise and, even when cases were found, there are a lack of treatment centres and other facilities to take them into.
That the local health infrastructure is overwhelmed by Ebola is immediately apparent.
In Kenema Government Hospital, some 30 medical staff alone have contracted the virus and died while caring for people in vastly sub-standard conditions.
Last weekend, Kenema District Medical Officer Dr Mohamed Vandy told the Irish Independent that macabre tales of some of the desperately-ill patients being left to go hungry in the treatment centre may be true because it is becoming too difficult to recruit staff to replace those who have died.
Among the medical staff working there who contracted the virus - and survived - was Briton William Pooley, who was airlifted to London and given access to an experimental drug ZMapp,.
ZMapp was also used successfully on two Americans.
The World Health Organisation has said it is hopeful a vaccine could be available for health workers to use by November.
There was no timescale on when – or if - it would be rolled out to ordinary people in West Africa.
Until then, the requirement for a large-scale, co-ordinated international response grows by the day – and US President Barack Obama’s belated promise this week of leading a “global response” while sending 3,000 troops to the region is a starting point.
Meanwhile, the ordinary people of Sierra Leone wait to be let out of their homes.