Gert van der Hoek
In Memoriam - Editor, Senior Moderator
SIERRA LEONE
Isolation capacity still inadequate, local healthcare workers struggling to cope
The fight against Ebola in Sierra Leone is being outpaced by the increasing number of infections.
Despite efforts by the national authorities and support from international actors, the situation is far
from under control. Every district in Sierra Leone is affected by the epidemic, and the number of
infections has increased alarmingly. The Western area (Freetown and suburbs) and Port Loko,
Bombali and Tonkolili remain zones with high case loads and ongoing transmission.
Foreign governments ? mainly the UK and China ? have sent teams to construct new centres in
different locations around the country, including Port Loko, Freetown and Makeni. In September, the
UK announced that it would construct and provide material resources for 700 additional beds(it would
be up to implementing partners to staff them). As of 27 November, only 11 of these beds were
operational, and only 28 patients had been treated. While the remaining centres are under construction
and scheduled to open soon, they will not be running at full capacity until well into the New Year.
Training is now being carried out by a number of actors, which is a welcome development.
Despite large pledges of assistance from the international community, the bulk of the hands-on work
with patients and communities is still being carried out by local people, the Sierra Leonean authorities
and NGOs. At the moment, in the Western area ? one of the most affected ? the vast majority of the
available beds for Ebola patients are operated by the Ministry of Health (MOH), with some support
from international agencies and governments like the UK, China and Cuba. About 50 per cent of the
available beds in all of Sierra Leone are operated by the MOH and the Sierra Leonean armed forces,
and another 40 per cent are run by MSF.
Isolation and supportive medical care for patients remains a critical issue: there are still not enough
operational beds for the increasing number of infections across the country. In MSF?s case
management centres (CMCs) in both Bo and Kailahun, the majority of patients are now coming from
other districts as there are insufficient case management capacities further afield. There is an acute
lack of bed capacity in Freetown and the Western region: this weekend, the MSF CMC in Kailahun
admitted 10 patients who had come from Freetown as there were no free beds closer to the capital.
Freetown is nine hours away by road.
In the absence of adequate facilities to isolate, diagnose and manage Ebola cases, Sierra Leonean
healthcare workers are struggling with the needs and are forced to face the epidemic with whatever
support they can get. MSF is deeply concerned about contamination of uninfected patients and
healthcare workers in existing healthcare facilities, where staff are not necessarily trained to manage
Ebola patients and where infection control measures cannot be assured.
MSF
Isolation capacity still inadequate, local healthcare workers struggling to cope
The fight against Ebola in Sierra Leone is being outpaced by the increasing number of infections.
Despite efforts by the national authorities and support from international actors, the situation is far
from under control. Every district in Sierra Leone is affected by the epidemic, and the number of
infections has increased alarmingly. The Western area (Freetown and suburbs) and Port Loko,
Bombali and Tonkolili remain zones with high case loads and ongoing transmission.
Foreign governments ? mainly the UK and China ? have sent teams to construct new centres in
different locations around the country, including Port Loko, Freetown and Makeni. In September, the
UK announced that it would construct and provide material resources for 700 additional beds(it would
be up to implementing partners to staff them). As of 27 November, only 11 of these beds were
operational, and only 28 patients had been treated. While the remaining centres are under construction
and scheduled to open soon, they will not be running at full capacity until well into the New Year.
Training is now being carried out by a number of actors, which is a welcome development.
Despite large pledges of assistance from the international community, the bulk of the hands-on work
with patients and communities is still being carried out by local people, the Sierra Leonean authorities
and NGOs. At the moment, in the Western area ? one of the most affected ? the vast majority of the
available beds for Ebola patients are operated by the Ministry of Health (MOH), with some support
from international agencies and governments like the UK, China and Cuba. About 50 per cent of the
available beds in all of Sierra Leone are operated by the MOH and the Sierra Leonean armed forces,
and another 40 per cent are run by MSF.
Isolation and supportive medical care for patients remains a critical issue: there are still not enough
operational beds for the increasing number of infections across the country. In MSF?s case
management centres (CMCs) in both Bo and Kailahun, the majority of patients are now coming from
other districts as there are insufficient case management capacities further afield. There is an acute
lack of bed capacity in Freetown and the Western region: this weekend, the MSF CMC in Kailahun
admitted 10 patients who had come from Freetown as there were no free beds closer to the capital.
Freetown is nine hours away by road.
In the absence of adequate facilities to isolate, diagnose and manage Ebola cases, Sierra Leonean
healthcare workers are struggling with the needs and are forced to face the epidemic with whatever
support they can get. MSF is deeply concerned about contamination of uninfected patients and
healthcare workers in existing healthcare facilities, where staff are not necessarily trained to manage
Ebola patients and where infection control measures cannot be assured.
MSF