Sierra Leone: Western Area Surge combats Ebola pro-actively

The Western Area of Sierra Leone is the “hotspot” in this Ebola outbreak at the moment, with the highest transmission of any of the 3 most affected countries. The Government of Sierra Leone, WHO and partners, are sending in a massive surge of staff and resources to this area to intensify efforts to curb the spread of Ebola disease.

Stephen (right) and Sambo (left) talk to a sick man in Freetown to determine if he should be tested for Ebola. WHO/Stephane Saporito

Screening for Ebola

Medical students Stephen Kamara and Samba Jalloh get on their motorbikes. They have received several alerts this morning from the Command Centre about possible Ebola infections in their area of Sierra Leone’s capital Freetown. Using a standard checklist, they will screen each sick person and evaluate if there is a need for the patient to be transported and tested for Ebola.

“This is a medical war my country is fighting and I believe that the only way to stop this disease is for us, health practitioners, to come on board. We need to identify all sick people and take them out of the community as soon as possible,” explains Stephen about his decision to join the Western Area Surge operation.

“This is a medical war my country is fighting and I believe that the only way to stop this disease is for us, health practitioners, to come on board. We need to identify all sick people and take them out of the community as soon as possible.” Stephen Kamara, medical student

The Ebola 117 hotline team based at the Command Centre sends alerts to Stephen and Samba when there is a call about a sick person in their neighbourhood. If they decide that the patient needs medical care, they call back the 117 hotline to send an ambulance to transport the sick person to the nearest holding centre for Ebola testing.

This work forms a key part of the Western Area Surge operation launched this week by the Government of Sierra Leone, supported by World Health Organization (WHO) and many other partners to intensify efforts to curb the spread of Ebola disease in urban and rural areas surrounding Freetown.

Urgent action needed

Across Sierra Leone, there are signs of a slowdown in number of cases reported. However, in the western part of the country, Ebola transmission remains intense and is currently considered the “hotspot” of the West African outbreak.

The emphasis of the surge operation is on convincing people to take personal responsibility for bringing this epidemic to an end – to put community before self. Ordinary people can save lives by calling the hotline to report possible Ebola cases or request a respectful burial.

The response targets Freetown and neighbouring areas to break chains of transmission by increasing the number of beds to ensure patients with clinical symptoms of Ebola are isolated and receive appropriate treatment.

Stephen and Samba are 2 of 180 district surveillance officers and 300 community monitors, trained by Ministry of Health, WHO and United States Centers for Disease Control (CDC) to work in their communities on active case finding, surveillance, contact tracing and social mobilization.

“We are ready to give support to the teams who are investigating the cases. This includes providing hands-on support when they have challenges and difficult issues to solve,” says Dr Fikru Abebe, WHO epidemiologist involved in providing support to the teams on the ground.

WHO is also training epidemiologists and clinical teams to staff new treatment centres as well as improving infection prevention and control standards in healthcare facilities, to maximize the protection of health workers and patients.

Epidemiologists are being trained and equipped to strengthen surveillance and contact tracing efforts in all the districts geared towards early case detection and supportive care.

Building a full-service response

The government and partners are all working with the public to show them the system can now handle the people who need help. Unlike in past months, there are now enough telephone hotline workers, case investigators, tracers, ambulances, hospital beds and staff, burial teams, laboratory systems for blood and swab testing, as well as people to coordinate, find and fix problems as they arise. With the current resources, we can step ahead of the outbreak instead of chasing it.

“We need not only to check all alerts indicated by the Command Centre but we also need to be proactive and search (for possible cases) in our community. Active search is the only way to win this fight once for all. Ebola is not our friend,” says Stephen.

The Western Area Surge operation will continue through to the end of December.