Ebola in the Democratic Republic of the CongoBoasting over 85 million people, Congo has struggled with political and social instability since the Belgian conquest in the early 20th century. To this day over 100 armed groups, including the Allied Democratic Forces, the Mai Mai and the Forces of the Liberation of Rwanda, are active in Congo. Against this backdrop of factionalism and violence quietly rages the second most deadly Ebola outbreak in history. Over 1,600 people have died. Despite these grim circumstances, a group of Congolese tech-savvy youth have developed an unlikely weapon against Ebola: an app they’ve called Lokole.

Fighting Ebola in Congo

Ebola is a virus that first causes fever, sore throat and muscle weakness and later progresses to vomiting, diarrhea as well as internal and external bleeding. Patients die due to dehydration and multiple organ failure. During the West African epidemic of 2014 to 2016, over 11,000 people died. During this epidemic, the investigational vaccine called rVSV-ZEBOV was used to fight the outbreak in Congo. However, it was used under the compassionate use clause because the vaccine had not been commercially licensed.

In addition, the Congolese Ministry of Health is seeking medical interventions through technological tools . Through collaboration with Internews and Kinshasa Digital, it organized a hackathon in March 2019, bringing 50 students in communications, medicine, journalism and computer science together. These students were sorted into teams of approximately seven.

Each team sought to answer the question: “How can Ebola response teams leverage new technologies to achieve their communication goals at the local, national and international level?” Thrown together for the first time, Emmanuel, Ursula, Aurore, Joel, David, Israël, and Maria worked for 24 hours. There, they came up with Lokole, the winning technology.

Introducing the Lokole App

Lokole is an Unstructured Supplementary Service Data (USSD) mobile application which “is designed to facilitate the real-time transmission of data and information between communities and the Ebola response teams,” despite poor internet connectivity in rural areas. This team of seven chose the name Lokole because a lokole is a traditional Congolese drum used to transmit messages over long distances. With this app, they hope to increase communication about the spread of Ebola in Congo.

USSD technology is a text-based communication system used by Global System for Mobile Communication (GSM) cellphones. Even though text-based communication might seem outdated with smartphones in the picture, smartphone use across Africa is at less than 35 percent. Plus, those with smartphones might not have access to data plans. As such, a real-time mobile to mobile communication platform based on USSD technology is inherently more inclusive, useful and cheaper.

The Lokole app allows community workers to note and document Ebola symptoms through questionnaires which are then relayed to Ebola response teams and the Ministry of Health. David Malaba, one of the app’s developers, says “Real-time management of information by the different components of the Ebola response will help detect and provide treatment to patients more quickly and deploy resources on the ground more swiftly, which will help lower Ebola mortality rates.”

While analog in comparison to smartphone technology, Lokole’s USSD platform offers the potential for real-time communication without having to invest in widespread expensive improvements in Congo’s internet connectivity infrastructure.

Changing the Future of Grassroots Healthcare

Since the virus’s discovery in 1976, Congo has had 10 documented Ebola outbreaks. Years of consistent violence has led to great mistrust of government and health authorities. Such widespread mistrust of health systems makes epidemics like Ebola even harder to combat.

However, Lokole empowers the everyday Congolese with the tools to fight Ebola. It is a democratic grassroots healthcare model. In fact, large-scale telemedicine platforms, such as BabylRwanda in Rwanda, are powered by similar USSD technology. This connects the average citizen with a nurse or physician in a matter of minutes.

The development of the Lokole app is exciting in its fight against Ebola in Congo, but the galvanization of local Congolese talent is a game-changer. Hackathons that bring disparate youth together to problem solve big and often overwhelming issues inspire others to pursue change. Lokole is just the beginning.

Sarah Boyer
Photo: Flickr

Ebola VaccineThe Democratic Republic of the Congo (DRC) is currently facing its worst outbreak of Ebola in the country’s northeastern regions, with over 2,000 declared cases, but in cooperation with the DRC’s government, the World Health Organization (WHO) has worked to provide Ebola vaccine for those who are at risk of contracting the virus.

First declared by the DRC’s government in June 2018, the Ebola outbreak has resulted in the death of over 1,000 people, and cases have also spread into neighboring Uganda. This outbreak is the second largest ever Ebola epidemic, after the outbreak that took place in West Africa from 2014-2016. There is worry that the virus could spread across the nation’s eastern borders or into major cities.

How the WHO is Combatting Ebola with Vaccines

The Ebola vaccine that the WHO uses is known as Merck’s V920, and was first employed in the early stages of an outbreak in the DRC’s Equateur province. The WHO was able to contain the virus and put an end to the epidemic in that province in under three months, although 33 people unfortunately still fell victim to the Ebola virus. When the DRC officially declared an outbreak, the Ebola vaccine, although still unlicensed, was employed on the grounds of compassionate use. The Ebola vaccine was highly effective, achieving a nearly 100 percent protection rate for more than 119,000 people living in the eastern provinces of Ituri and North Kivu.

The WHO is following a “ring vaccination” strategy, which proved successful in fighting the epidemic in Equateur. In this strategy, all those who are known contacts of people who contracted Ebola are offered the Ebola vaccine. Then, the WHO offers the vaccine to any contacts of those, as well as to anyone classified as at particularly high risk of contracting the virus, such as healthcare workers. By forming a ring of immunity around someone that is confirmed to have Ebola, they are able to reduce the chance that the virus will spread.

However, the ring vaccination strategy is quite time consuming, as it requires what is known as “contact tracing” in which every single person diagnosed with Ebola must disclose every single person that they might have been in contact with. By following this ring vaccination strategy, the WHO was able to vaccinate more than 119,000 people from August 2018 to May 2019. However, despite the vaccine’s high success rate, the number of cases continued to grow. Due to increased occurrences of violence in the country, it is more difficult for aid workers to build these vaccination rings around those who are at risk.

Modifying the Vaccination Strategy

On May 7, 2019, the WHO’s Strategic Board of Experts (SAGE) announced new recommendations that would significantly modify the vaccination strategy in order to strengthen their fight against the virus. These new recommendations focus on adjusting the dosage of the vaccine, offering an alternative vaccine for those that are at a lower risk of contracting Ebola, expanding the scope of people that are eligible for one and working to accelerate the vaccination process. In addition, SAGE recommends that the WHO provide a different vaccine to those in affected areas that are at a low risk. Johnson & Johnson have developed a MVA-BN vaccine that is currently being investigated and is at an advanced stage in moving towards deployment.

In order to expand the scope of people that can receive the vaccine, the WHO will begin to establish “pop up” vaccination sites in villages so that everyone in an area who consents to the vaccine can receive it (the WHO says that 90 percent of people consent to the Ebola vaccine). SAGE recommends that the WHO also work to vaccinate members of neighborhoods and villages where a case has been reported within the last three weeks. Vaccinating entire villages will ensure that the virus’s movement is limited, and will definitely make it much easier to contain.

Together with the DRC’s government, WHO has made great strides in fighting against the Ebola outbreak and working to contain the virus. In establishing the ring strategy that focuses on vaccinating individuals that may have been in contact with the virus, the WHO has been successfully able to build rings of immunity. The WHO has used the highly efficacious Merck’s V920 vaccine to vaccinate over 119,000 people and continues to research additional vaccines and strategies. The WHO continues to refine their approach so they can contain the Ebola epidemic as soon as possible and save as many lives as they can.

– Nicholas Bykov
Photo: Boston University

Distrust Breeds EbolaMore than 1,100 people in Congo have died due to the recent Ebola outbreak. New treatment facilities, additional health personnel, improved vaccinations, and awareness campaigns should effectively be controlling the spread of Ebola. In spite of this, distrust is breeding Ebola as citizens reject available aid.

However, violence and distrust are increasing the risk of Ebola in Congo. This Ebola outbreak is the second worst outbreak in history and the solution is extremely complicated. Local militias in Congo have been burning down clinics and threatening physicians since January. Historically, residents have had to fear for their own safety and flee local armed extremist groups.

Distrust of Aid

Now, with the recent outbreak of Ebola, already vulnerable communities are experiencing a double layered threat of violence and disease. Reports show that the number of people infected with Ebola rises after violent conflicts. These areas are often unsafe for health workers, increasing the risk for Ebola to spread. Much of the violence pointed toward clinics and health workers stems from a widespread distrust of the government and foreign aid. This distrust is breeding Ebola, unnecessarily increasing the risk of contraction.

Despite these challenges, many international organizations are still trying to control the spread of Ebola in Congo and provide aid to those already infected. The World Health Organization reported 119 attacks on health workers. This has inspired international organizations to approach their methods for care differently. Aid workers are attempting to provide correct information to the population in Congo in order to debunk the propaganda being spread about the government and international aid. Often in public, health workers downplay their role to try and build trust within communities. The International Rescue Committee states, “Our staff has to lie about being doctors in order to treat people.”

Continued Support

The New Humanitarian is exploring why a deep distrust of government and foreign aid exists in Congo. Social media seems to be a large player in spreading misinformation. As such, 86 percent of adults surveyed in Beni and Butembo stated they do not believe that Ebola is real. Others believe Ebola is a method used by the government to destabilize certain areas. Similarly, many people fear treatment centers are making Ebola worse. Facebook and WhatsApp are major players in spreading this false information. The Ministry of Health has said they are working to monitor these pages and adapt local messages to make sure the truth is out there.

The control of Ebola is entirely possible through vaccines and prevention efforts. Instead, distrust is breeding Ebola in Congo as risk increases. Working to end this distrust and limit violence toward health workers through the spread of true information, is essential in stopping the spread of Ebola. The World Health Organization, the Center for Disease Control and other health agencies and organizations are working to provide more aid to those affected by Ebola, hoping to prevent spread beyond the region.

Claire Bryan
Photo: Flickr

Eye Care for Ebola SurvivorsWhile Ebola killed more than 11,000 people in just Western Africa in 2014-2015, the thousands who survived are now at risk of developing vision loss face issues caused by the infection. These survivors commonly face vision problems, ranging from uveitis (a form of eye inflammation) to optic neuropathy to panuveitis (inflammation of all the layers of the uveal tract).

One study found that nearly 40 percent of the people observed developed an ocular disease. The most common symptoms were blurry vision and photophobia — sensitivity to light — observed in 76 and 68 percent of patients, respectively. Tearing, pain, floaters and redness in the eyes were also prevalent. Many of those examined also had glaucoma and retinal detachment.

The Congo’s Reaction to the Latest Ebola Outbreak

Learning from previous outbreaks, the Ministry of Health in the Democratic Republic of the Congo recently set up a clinic in Beni to provide eye care for Ebola survivors. This is the first time that follow-up eye treatment has been offered so soon after patients have been released from care. A similar clinic has also been established in Butembo, another heavily affected area.

Survivors of Ebola have helped establish this clinic, providing aid and community outreach in this time of need. Emory University and the University of North Carolina have also donated ophthalmologists to help the effort get on its feet. Organizations, such as the WHO, are also working with the Ministry of Health to keep the clinics thriving.

So far, 250 people have been seen and examined. From their initial tests, complications like uveitis were low compared to previous outbreaks. Plans are also in place to train 10 Congolese ophthalmologists on Ebola-related issues in order to expand treatment options for patients. Over the following months, more clinics will be established to accommodate more than 300 patients who are on the waiting list.

The Need for Screening

While it remains unclear as to why Ebola affects people’s vision, it is clear that there is some correlation. Some studies show that Ebola may lead to uveitis because a higher viral load enables Ebola to enter the eye and establish viral persistence, which later leads to uveitis.

Doctors are finding that eye care for Ebola survivors relies heavily on early screening. One study showed that patients who were promptly screened for an initial assessment for the disease were easier to treat and at less risk for reduced vision. While more research is needed to determine the links between Ebola and visions loss, the establishment of clinics in disease-prone areas is a step in the right direction.

– Michela Rahaim
Photo: Flickr

Ebola Epidemic in the Democratic Republic of the Congo
On May 8, 2018, The Ministry of Health in the Democratic Republic of the Congo (DRC) declared an outbreak of the virus disease Ebola in the North Kivu Province. The Democratic Republic of the Congo declared the epidemic over on July 24, 2018. This represented the ninth Ebola epidemic in this African country since 1976.

The Development of Ebola Epidemic in the Democratic Republic of the Congo

The disease had been slowly building to the epidemic, even catastrophic levels. According to The World Health Organization (WHO), the country had seen and been aware of the virus in the area since the April 4. The organization reports that, in April, a total of 44 people had been infected with the Ebola virus, which included 23 deaths.

However, in May, this number was disputed, as only 3 new cases were confirmed. The World Health Organization later narrowed the origins of this particular epidemic and found that it began in the northwestern area of Bikoro, which was the place where first cases were recorded on May 8. From this, The World Health Organization identified nearly 400 contacts of Ebola victims that are currently and continuously being followed up.

The History of Ebola Outbreaks in DRC

This isn’t the first Ebola outbreak the country has seen, however. Though Ebola outbreaks are uncommon, the Democratic Republic of Congo has experienced multiple flare-ups of the virus- nine since 1976. One such flare-up happened in not so distant past, in 2017 to be exact, with five confirmed cases that were quickly dealt with. The fast response and eradication convinced many, including the World Health Organization and health officials that the 2018 Ebola epidemic in the country will be easily dealt with. Yet, this prediction proved to be optimistic and naive since, within a month of declaring the outbreak of an epidemic, two health officials were among those affected.

The Declaration of Epidemic

The World Health Organization was very quick to declare this year’s Ebola epidemic in the Democratic Republic of Congo as a global emergency to public health. Unlike the Ebola epidemic that ravaged Western Africa in 2014, The World Health Organization declared a state of emergency in the Democratic Republic of Congo swiftly after seeing the number of cases increase.

Moreover, the organization made an immediate urgent request for $57 million to stop the spread of Ebola. In total, the money received amounted to $63 million, exceeding the appeal by $6 million. Among those who contributed to the funding towards ending this Ebola epidemic in the DRC was USAID who contributed with $5.3 million.

On July 24, 2018, Al Jazeera reported that the Ebola epidemic in the Democratic Republic of Congo has been declared over. The virus had lasted a total of 10 weeks and had taken a total of 33 lives. Fortunately, the disease had remained contained, as Bikoro, the epicenter of the epidemic is a remote area of the country.

Although the people that were infected as a result of last Ebola virus in the Democratic Republic of Congo have completed their treatment, and have thus been declared cured, the health ministry of the Democratic Republic of Congo, as well as The World Health Organization are monitoring the situation in the country closely to ensure the virus does not spread.

Isabella Agostini
Photo: Flickr

History of Ebola in Senegal
The outbreak of Ebola in Senegal became official at the end of August in 2014. A young man who had traveled from Guinea—a country already inflicted with Ebola—to Dakar (the capital city of Senegal) was confirmed to have the virus. The WHO immediately jumped into action and sent three of the world’s best Ebola epidemiologists to contain the disease and prevent spreading.

Symptoms of Ebola

The first symptoms of Ebola are like the typical signs of flu such as a headache, fever and chills. It spreads through contact of bodily fluids resulting in internal bleeding and organ failure. A person with a late stage of the virus often shows symptoms such as coughing up blood.

The disease has a fatality rate of up to 90 percent. Ebola can be contracted from the bodies of those who died from it, particularly when relatives bury them without protective gear.

About the History of Ebola in Senegal

Senegal was in a relatively advantageous position when Ebola struck their country because they had time to prepare as they watched it spread in neighboring countries. A National Crisis Committee was established quickly, to which funds were allocated in order to suppress the virus. To be safe, the government of Senegal expanded the eradication plan nationwide in response to the single case found in Dakar.

The fight against Ebola started with locating every person that came in contact with the first infected man in the country. After 74 people were identified, they were monitored intently to watch for signs of symptoms. The few that showed any symptoms similar to that of Ebola were tested, and all tests came back negative.

The infected man was treated in a hospital and recovered fully. He was allowed to re-enter the society once it was decided he was not carrying any contagion.

Around the time that Ebola broke out in Senegal, the country closed its borders to travelers from Liberia, Guinea and Sierra Leone. This safety measure was taken in response to the massive epidemic of Ebola in those countries. The president of Senegal stated publicly that it should not just be an African emergency, but a global priority.

Senegal was lucky in comparison to its neighbors. The case of Ebola in Senegal is a perfect example of the positive effects proactive measures can have. Because Senegal took precautions before Ebola was found in their country, they were prepared for the disease when it was discovered.

Ebola-Free Senegal

A major factor in the success of Senegal’s fight against Ebola is the awareness they had about Ebola’s advances in their surrounding countries. Some of the measures Senegal took could be seen as excessive, but their “better safe than sorry” attitude contributed significantly to their Ebola-free status.

After the standard 42-day waiting period for Ebola cases, Senegal was declared Ebola-free by WHO on October 17, 2014. The country has not had another case since.

When the government of a country prioritizes the safety and health of its people, innumerable lives are saved. The diligence of Senegal ensured there was no more than one case found and no deaths from Ebola.

Even a disease as fatal and severe as Ebola can be prevented when fought effectively. Other nations can use Senegal’s response to Ebola as a role model for how to fight the disease.

– Amelia Merchant
Photo: Flickr

History of Ebola in Guinea
A rapidly spreading virus with a high fatality rate and no cure, Ebola was first recorded in Guinea in 2013 with the death of a local two-year-old boy. This marked the first outbreak of Ebola in all of West Africa. Since then, the highly fatal virus has been spreading throughout neighboring countries such as Sierra Leone and Liberia, leaving a trail of death behind it.

History of Ebola in Guinea: A Look at the First Case

A two-year-old boy living in the remote village of Meliandou, Guinea, Emile Ouamouno is the first recorded case of Ebola in West Africa. According to the EMBO Molecular Medicine journal, researchers believe Ouamouno was playing with bats in a hollowed tree trunk when he contracted the virus. He died two days later after battling a fever, vomiting and black stool. His mother, sister and grandmother expired soon after. The deadly virus was spreading. In a span of four months, residents of Meliandou buried 14 people due to Ebola. By March, the virus had emerged in Sierra Leone, Liberia and Nigeria. Panic began to set in around the globe.

Containment and Quarantine in Guinea

It wasn’t until months later that Ouamouno’s death was recognized as Ebola. On March 23, 2013, the World Health Organization (WHO) announced the outbreak in Guinea and reported that 49 people were already infected.

The same month, Guinea’s President Alpha Conde declared a 45-day national health emergency. In a national statement, Conde banned those who had contact with Ebola victims from leaving their homes and anyone who disregarded this measure was “a threat to the public and will face the might of the law.”

Transportation and travel came to a halt. Ebola is transmitted through bodily fluids such as spit or blood and handling infected bodies can also lead to contraction of the virus. Border control in Guinea intensified and travel restrictions increased. However, none of this could stop animals that cross borders effortlessly, carrying the virus with them. The history of Ebola in Guinea continued to rage on.

The Illusion of Elimination

Heavily stigmatized by society, Ebola victims would often hide their illness and continue to interact with society. With an incubation period of up to three weeks, it is impossible to test positive for Ebola until symptoms show. By then, it might be too late. Villages quarantined themselves out of fear.

Others doubted the very existence of Ebola. A member of the Fula ethnic group had a different explanation. “This outbreak isn’t real. How could we be having Ebola here?” he said. “President Conde made it up because he’s trying to delay elections.”

Ebola continued to spread in 2014 with no end in sight, despite educational campaigns and international health workers. In fact, the health workers contributed to the conspiracy theories. Dressed in all yellow, moving stiffly and setting up quarantined tents where loved ones entered and never returned prompted fear in the locals. Some villagers began to spread rumors that the medical workers were harvesting organs and stealing limbs. The number of people willing to enter quarantine tapered off.

Reemergence of Ebola in Guinea

In late May, the last case of Ebola in Guinea was symptom-free for 21 days. President Conde announced, “for the moment, the situation is well in hand.” International medical workers began to depart the country and communities let out sighs of relief. At that moment, the nightmare was over.

In late July, a new patient was admitted. By the end of the month, dozens more from all over Guinea. The presence of Ebola in Guinea continued and was worse than ever.

The Deadliest Year

In 2014, more than 1,500 people died from Ebola in West Africa. Meliandou. This is where Ebola began in Guinea with the death of Emile Ouamouno, only to be isolated and ostracized from the national community. Surrounding villages refused to trade and vehicles were scared to enter the borders. In Meliandou, Ebola became less of a concern as people began to suffer hunger and poverty.

Free of Ebola

On December 29, 2014, Guinea was declared free of Ebola. However, Guinea was still in a state of heightened surveillance for the next three months. More than a year passed with Guinea recovering from the health emergency and mourning those who died.

In March 2016, two people in Guinea tested positive for Ebola. Fear began to creep up again in local communities. By March 22, 2016, more than 816 people in contact with the individuals had been quarantined and Liberia closed its borders with Guinea.

On April 1, 2016, an experimental vaccination was used on those with suspected contact with infected individuals. On April 5, 2016, it was reported that nine new cases of Ebola emerged in Guinea. Eight died. The WHO implemented a short incubation period and on June 1, 2016, declared Guinea free of Ebola. At last, the history of Ebola in Guinea came to a close.

Photo: Flickr

History of Ebola in Liberia
The first outbreak of Ebola in Liberia was documented in March 2014. By June of that year, Ebola began to take lives. On August 6, the president of Liberia declared a state of emergency, closed schools, and established an Ebola task force.

In her statement on August 6, President Ellen Johnson Sirleaf stated, “The virus currently has no cure and has a fatality rate of up to 90 percent. The aggregate number of cases: confirmed, probable and suspected in Liberia has now exceeded 500 with about 271 cumulative deaths. With 32 deaths among health care workers. The death rate among citizens, especially among health workers is alarming.”

Development of Epidemic

In mid-August, the Ivory Coast banned all flights traveling to or from Liberia. Ebola had also spread to neighboring countries, including Guinea and Sierra Leone. Multiple clinics began opening in Monrovia, country’s capital, and across the country, but they did not have enough space to house all those inflicted, and many people died outside hospitals waiting for care.

The president of Liberia requested international assistance in early October of 2014, and on October 16, President Barack Obama granted the use of the National Guard and reservists in Liberia.

At that point, nearly 4,500 people had died from Ebola in Liberia, Sierra Leone and Guinea. The military personnel sent by the U.S. assisted in building clinics and providing humanitarian assistance.

Working on Ebola-free Country

World Health Organisation (WHO) began to implement its 70-70-60 plan to curb the epidemic. The goal was to get 70 percent of the cases isolated and 70 percent of the deceased buried safely within 60 days starting on October 1, 2014. WHO also worked with Liberia’s Ministry of Health to train health care workers on how to safely treat patients that were infected.

In November 2014, WHO reported that there was evidence of a decline of new cases of Ebola in Liberia. In January 2015, clinics that had been overflowing began to close due to a lack of patients.

As of January 28, 2015, there were only five reported cases of Ebola in Liberia. The prevalence of the disease began declining significantly over the next year.

On the May 9, Liberia was declared Ebola-free and three months passed without a recurrence of the disease. Medecins Sans Frontieres encouraged people to stay aware of the disease coming back after the announcement of the eradication.

A few new cases were found in the summer of 2015, but they did not lead to another significant outbreak. Liberia continued to be declared Ebola-free on and off for every 42-day period that passed without a reported case. Most recently, Liberia has been Ebola-free since June 9, 2016.

The Causes for Epidemic Spreading

The massive outbreak of Ebola in Liberia has been contributed by lack of sanitation, corruption and hiding of bodies/diseased people, among others factors.

Many Liberians did not report cases of Ebola or deaths due to it. Instead, they were self-treating and burying bodies in unsafe places. This practice led to the disease spreading at a faster pace.

Lack of sanitation was a major contributor, as many Liberians in Monrovia use the beach and the river as a lavatory. Without sanitary spaces, Ebola was able to run rampant. Additionally, it was reported that body-collection teams would accept bribes from families who did not want people to know their relative died of Ebola. Instead of collecting the body, the teams would leave it with the family so they could host their own funeral.

Thankfully, Liberia has been Ebola-free since 2016 and is now better equipped to handle an outbreak it was to return.

– Amelia Merchant

Photo: Flickr

History of Ebola in Mali
History of Ebola in Mali began in October 2014 when Aminata Gueye Tamboura tried to protect her (non-biological) granddaughters from the Ebola outbreak in Guinea. They traveled back to her home in Mali by taxis, buses and public transportation, while one of the girls, Fanta Condé, had symptoms of fever and nosebleeds. The two-year-old was brought to the Fousseyni Daou Hospital and was diagnosed with Ebola on October 23. One day later, she passed away.

The Spread of Ebola in Mali

Condé’s diagnosis was especially alarming because of the amount of people she could have made contact with throughout their journey to Mali. Once notified, WHO tracked down and quarantined 108 people who may have been exposed to Condé. Notably, no one in that group showed symptoms throughout the 21-day quarantine and were released in November.

On October 27, a few days following Condé’s death, another Ebola victim passed away. The imam had travelled to Mali from Guinea in search of a treatment for kidney failure he had for about one month. While doctors did not diagnose him, kidney failure is associated with late-stage Ebola. Soon after his visit to the Pasteur Clinic in Bamako, a nurse became sick and died, raising concerns about Ebola. On November 11, the nurse’s diagnosis of Ebola was confirmed. The hospital and areas that the imam and nurse had visited were quarantined, allowing health authorities to learn that a doctor at the clinic had Ebola as well.

Preventing the Spread of Ebola in Mali

In response to these outbreaks, emergency teams made from organizations such as WHO, Medecins Sans Frontieres, the United Nations and others were deployed in Mali. Certain groups already had a presence in Mali due to its shared borders with countries with Ebola outbreaks, allowing them to immediately take action. The history of Ebola in Mali was dramatically shorter than in neighboring African countries, largely because of the efforts of these organizations.

WHO, for example, was able to test blood samples in hours, hastening the process of diagnosis. They trained over 900 health workers to appropriately handle the outbreak. Preventative measures were taken as well; WHO provided hand washing facilities and temperature checks at hospital entry points.

In accordance with the tradition of diatiguiya, Mali did choose to keep its borders open. It continued to practice hospitality with its neighbors, despite the challenging circumstances at the time. Health checks were put in place, however, as preventative measures.

By January 6, 2015, the CDC had removed travel warnings in Mali, deeming it safe. On January 8, Mali was officially declared Ebola-free. The last Ebola patient tested negative on December 6, 2014, and no cases of ebola have come about since. The history of Ebola in Mali lasted a short few months because Mali effectively contained the virus wherever it appeared. In other West African countries, people were reluctant to believe in the Ebola virus and did not adhere to the recommended precautions, but Malians were more cooperative. The joint effort of citizens and aid groups ultimately lead to the successful containment of the Ebola virus in Mali.

– Massarath Fatima

Photo: Flickr

A Brief History of Ebola in Sierra Leone
The history of Ebola in Sierra Leone can be traced back to December of 2014. The illness started out slow and unsuspecting as it crept across the land until really solidifying its grasp in May and June.  From then on, the cases of Ebola continued to increase at an exponential rate.

The First Case and Subsequent Infection

The first case was that of an eighteen-month-old boy from a small village in Guinea. He was thought to have been infected by bats in the region. Soon after, other reports of Ebola-like symptoms became rapidly apparent. In March alone, there had been a reported 49 cases and 29 deaths.

One of the next infected was a house guest to the family of the index patient. She traveled home to Sierra Leone from Guinea unknowingly carrying the Ebola virus with her. She died shortly after her return due to the disease; however, her death was not investigated or reported until two other members of her family died.

The epidemic really began to flourish after the death of an infected traditional healer. The healer would treat Ebola patients across the border in Guinea but was a resident of Sierra Leone.

She eventually succumbed to the disease and a funeral service was held on her behalf; this is where the spread in Sierra Leone really increased. Thirteen women, all of whom attended the funeral, contracted the disease and eventually died as well.

A Death-Giving Funeral

Investigation processions commenced proceeding the funeral induced infections and it was found that 365 Ebola-related deaths started from that very funeral. It was also recognized that there were two strands of the virus present amongst the infected from the funeral.

In knowing the two variations of Ebola, researchers were able to retrospectively look for and trace the disease in blood samples. This made the containment of Ebola in Sierra Leone and respective infected regions much easier.

By the summer of 2014, the major town of Kailahun and its neighboring city Kenema were declared to be in a state of emergency. The World Health Organization (WHO) and other affiliated aid agencies provided and concentrated their response teams in the area.

The Ebola Epidemic

Unfortunately, the unsatisfactory public health infrastructure, the impoverished living conditions and the lack of preparedness aided the rapid spreading of the disease. By halfway through July, the aid teams from the World Health Organization buried over 50 bodies in the span of just 12 days in Kailahun alone.

Approximately two years after the first Ebola case was discovered, there were 28,600 cases and a resulting 11,325 deaths reported. The epidemic finally came to an exhausted end when Sierra Leone declared itself officially Ebola-free in March 2016.

Constant Vigilance

Unfortunately, the history of Ebola in Sierra Leone has continued in 2018 as the virus reared its ugly head again in May. The vigilance in regards to Ebola in Sierra Leone improved tremendously over the years since the first epidemic but it is still quite difficult to contain and extinguish.

Countless families and civilians still face the mental effects of the calamity from both the initial epidemic and the most recent devastation.

– Samantha Harward

Photo: Flickr