By Lisa O’Carroll-(The Guardian)…..
Sierra Leone is expected to be declared Ebola-free by the World Health Organisation on Saturday, when it will have gone 42 days without any fresh case of the virus. The West African country is expected to be declared Ebola-free on Saturday but optimism remains cautious with the virus still afflicting neighbouring Guinea
Celebrations are being prepared but the optimism is tempered by caution because the virus is still affecting neighbouring Guinea, which has recorded four cases in the past fortnight.
In a grim reminder of how the virus cuts through families, all four patients are siblings, infected by their mother. She had tested positive after caring for her sister who died of the disease.
The young people left in charge of children in Sierra Leone are struggling to provide food for their siblings let alone pay for their schooling or find a job
Three of the children, aged between three and 10, were infected in the week leading up to 25 October. The fourth is a baby, born last Wednesday, to the children’s mother, who died after the baby was delivered at just seven months. Against all the odds, the baby survived and is being treated in an Ebola unit.
In Sierra Leone’s capital, Freetown, doctors who led the fight against the disease that first hit the country in May 2014 said lessons had to be learned from Liberia, where one isolated case, thought to have been transmitted sexually, was recorded weeks after the country was declared Ebola-free in May.
There is also concern about long-term side-effects, heightened by the case of Scottish nurse Pauline Cafferkey, who became critically ill with meningitis caused by the lingering virus, nine months after being given the all-clear.
“We cannot stop at 42 days. We keep up the infection control and be hyper-vigilant because of what we found in Liberia and because of the case of the Scottish nurse,” said Dr Foday Sahr, who runs the Ebola treatment unit (ETU) at 34 Military hospital in Freetown.
“This country has suffered quite a lot so everybody is looking forward to zero, but I keep telling people we cannot be complacent,” he added.
The disease has killed 3,589 people in Sierra Leone, 221 of them health workers, including 11 of the country’s 120 doctors.
Overall the death toll for the outbreak in west Africa stands at 11,313, including a handful of cases of people from the US and Europe who contracted the disease while in the region.
More than $2bn was poured into West Africa over the past 18 months to contain what emerged as the deadliest Ebola epidemic in history. The focus of the WHO now is on ensuring each country is prepared for continuing isolated cases and for future side-effects, which include loss of vision, hearing, chronic fatigue, joint pain and meningitis.
As part of Sierra Leone’s National Ebola Response Centre transition plan, eight ETUs are still operating this week, but the number will be reduced after 7 November.
Medical charities Médecins Sans Frontières and International Medical Corps have scaled down operations dramatically, but will maintain a presence in the country.
IMC still employs almost 500 nationals and 61 ex-pat workers. While its large ETU in Bombali district will close, its centre in Kambia, which borders Guinea, will remain open. MSF has 306 international and national staff in Sierra Leone, compared to around 960 last year.
“The staff are of course excited at the prospect of reaching zero… but as long as there is Ebola in the region there is always a threat. There is still a huge amount of work to be done rebuilding a health system badly damaged by the virus,” said a spokesman for IMC in Sierra Leone.
Oliver Johnson, a British doctor who was at the forefront of the battle against the disease before international aid arrived, said 7 November was “a really important milestone” after a “devastating period in the country’s history”.
Johnson, who was until recently director of the UK’s King’s Sierra Leone Partnership at the Connaught hospital in Freetown, said that while vigilance was vital, there were now strong systems in place to manage and lock down any future cases, such as the country’s first proper infectious diseases ward at the hospital.
The end of Ebola will also mark a fresh opportunity to haul the country out of the economic doldrums. GDP contracted by more than 20% as investors fled and one of the country’s mining industries collapsed following an iron ore price crash in 2014.
Airlines that abandoned the country last year, including Air France and Kenya Airways, have resumed flights and there are plans for a new commercial carrier to fly direct between Gatwick and Freetown from 20 November pending the lifting of a British government ban. The application for the route licence is currently with the authorities.
“This moment is a signal to the world that Sierra Leone is safe and back open for business, be that by reopening flights, increasing investment in the private sector or travelling to this wonderful country as a tourist,” said Francis Kaikumba, director of the King’s Sierra Leone Partnership.
Kaikumba called on the international community to commit “to a significant and sustained investment in strengthening the country’s health system so that an outbreak like this can never happen again”.