Western Africa’s Ebola situation has worsened dramatically

The vocational school of Makeni in Sierra Leone is closed due to the national state of emergency declared because of Ebola. The graduates of the catering line prepared a celebratory dinner for guests of the graduation in January. Photo: Antti Reenpää

Hard to believe now, but only last spring, there was a rather unusual radiohit in Liberia. The title – “Ebola in town” – considered a funny dance track. Liberia, and indeed the whole region, now have a much more serious perspective on this deadly disease. Now, the schools are closed. Football matches and other public events are forbidden. Liberia and its’ neighbouring country, Sierra Leone, have declared a state of national emergency; Guinea has already closed its borders.

”The government of Liberia has ordered most of its public sector employees to stay at home, at least until the end of month”, says Jussi Laurikainen, Finn Church Aid’s Programme Coordinator working in Liberia.

No one can say that the officials are not taking the Ebola epidemic seriously now. The regional governments are trying to isolate the worst Ebola areas and restrict people’s movements in an effort to stop the spreading of the virus.
“The restriction measures, like road blocks, however, have so far been limited, “says Laurikainen.

The presidents of Sierra Leone and Liberia also decided not travel to the Africa Meeting held in Washington D.C. by President Obama. It’s another sign that the national crisis is finally being taken very seriously.

The virus from remote districts has found its way into cities

The Ebola epidemic spreading in West Africa is spreading on an unprecedented scale. By the 9th of August, Guinea, Liberia and Sierra Leone have reported 1848 confirmed cases. The number of people who have perished from the disease is 1013. World Health Organization  declared Ebola as an international health threat last Friday.

Ordinary West Africans have also noticed the deadliness of the disease. Monrovia and Freetown, the capitals of Liberia and Sierra Leone have been quieter than usual.

This is also the first time that the epidemic has spread into large cities.

“There are no normal morning and afternoon traffic jams. Restaurants are very quiet. Many have decided to keep their families completely indoors,” Jussi Laurikainen says from Monrovia.

“Monrovia isn’t a ghost town, however. People are walking in the streets, running their errands and children continue to play. The stores and shops are open as usual, but there is a canister with a tap in front of every store, as ordered by the government. Hands must be washed with soap and chlorinatede water before entering,” Laurikainen describes everyday life in the city.

Radio and village meetings spread information

The first and most important action against Ebola is how to spreading information in an understandable form. In Liberia, this key measure was implemented too late and not coordinated effectively.

“There were different songs played oin the radio about Ebola, mixed with messages from political leaders and authorities’ about the disease,” Laurikainen says.

The other central channel for information about Ebola has been village meetings. In the remote regions, where the level of education is almost non-existent and beliefs and traditions are very strong, spreading information and changing attitudes is very difficult.

“The usual line of ‘Ebola kills and there is no cure’ of government officials has not been the best approach according to the experts. Knowledge of the fact that there’s no cure is not encouraging people to seek treatment or report cases. Why even bother, some might have thought,” Laurikainen ponders.

Right now, it seems that the current mortality rate is not as dramatic as it has been in the earlier epidemics, where it was about 90 percent. According to WHO’s estimate, 55 percent of infected people in West Africa have died.

“75 percent of the deceased are women, because nurses tending the sick are often women. It is also women, who care for the sick and wash the deceased in families. The disease spreads easily this way,” says  Laurikainen.

Work at the grassroots level continues

Finn Church Aid’s work in Liberia and Sierra Leone is focused on improving livelihood and vocational training.

“We are currently finding out about Ebola’s effect on our programmes. For example, four of the vocational schools that we support in Sierra Leone are closed until further notice due to the orders of the government, and there is no information yet when they can be reopened,” says Jussi Laurikainen.

Activities of the henhouse programmes have become more difficult to carry out, because chicken feed has become unavailable, due to the closing of land borders.

”Health education has not been a part of FCA’s basic operations, but for example in the supported vocational schools in Sierra Leone there has been health education the curriculum. We are now finding out about the desire and capabilities of our partner organisations to do health education,” Laurikainen says.

“Education about Ebola is best connected with the ongoing action, where the structures are already in place. FCA’s partners are working on this important local and grassroots level.”

Officials and a few employees from organisations giving education about Ebola have received hostile reactions from locals, and in some cases, even outright violence.”

“Many are uncertain, and possibly afraid. Long internal conflicts in Liberia and Sierra Leone ended just ten years ago. People had to experience enormous suffering and learned to survive them. Ebola has, however, created a completely new and different situation, which is harder to grasp and understand,” Laurikainen says.

Months of epidemic still to come

Government actions are starting to take an effect, and more international help is being received in the country. Many organisations are also  providing health education.

“The number of contagions and mortalities will probably rise, when tracking the possibly infected gets more effective,” Jussi Laurikainen estimates.

“People are very mobile, and not everyone wants to give out information because of the fear of consequences, like isolation of loved-ones.”

All the earlier Ebola epidemics in Africa were able to be put under control, but they were confined in remote regions. Now the epidemic has spread over three countries, and for the first time, into capital cities.

Schools are closed for the time being, and the start of semester is being moved.

The rainy season, lasting from April until October-November, adds malaria and typhoid cases. Their symptoms are similar to Ebola’s first symptoms, and the weak healthcare structure is put under more strain.

Liberia’s road network is very basic, especially in remote regions. Due to heavy rainfall, the roads deteriorate and the weak telecommunication links also short out often.

“The locals are especially concerned about rising prices, if prices for staples goods like rice, cassava flour or cooking oil shoot up. Prices have already risen, but not dramatically so far. If the prices continue to rise, we cannot rule out unrest and riots,” Laurikainen estimates.

“Even in best case scenario, it will take months for the situation to be declared over.”
Text: Minna Elo

Finn Church Aid’s Programme Coordinator Jussi Laurikainen from the Monrovia office moved to work in Accra, the capital of Ghana this weekend. The coordinator for Humanitarian Aid working in Monrovia will work in Paris for the time being. This solution is based on the rapid deterioration of healthcare services and the possibility that exiting the country is becoming more difficult, if airlines discontinue flights.

FCA’s West African office was opened in 2008. Our work in Liberia pre-dates that since we have been supporting Lutheran World Federation’s work in Liberia.