Ebola makes last stand in headstrong village
SIRENS blared as the convoy of government vehicles made its way down a narrow dirt road nearly encased by tall weeds. The prime minister had arrived, and he was there to give this rural community a serious scolding.
“I demand the co-operation of the population,” Prime Minister Mohamed Said Fofana hollered from his makeshift bamboo stage.
“Ebola is gone everywhere — except here,” Fofana told the 300 people or so gathered around him. “The eyes of the world are on Tana village.”
After nearly 22 months and more than 11 300 deaths, the deadliest Ebola epidemic in history has come down to a handful of cases in a cluster of villages in rural Guinea, the country where the outbreak began.
Liberia, where more than 4 800 people died, has gone about two months since its last Ebola patient was discharged.
Sierra Leone, where nearly 4 000 died, was declared officially free of Ebola last Saturday, a milestone defined as 42 days without a new infection.
And while the virus once raged in Guinea, now it is merely smouldering, with seven new cases reported in recent weeks. Yet it is proving frustratingly difficult to stamp out altogether.
“Getting to zero” has bedevilled governments and international health experts for months. Workers from aid groups have descended on the villages where the virus is still spreading, a promising experimental vaccine is being given to adults who have been in contact with a victim, and government officials, once reluctant to acknowledge the dangerous outbreak, are helping to wipe it out.
But even with hundreds of millions of dollars spent to fight this outbreak, the approach to stamping out the disease remains uneven, at best. Workers are still making rookie mistakes. Guards at Ebola checkpoints skip some passengers for fever checks. Health workers use bare hands to touch people who might have the virus. Isolated communities experiencing Ebola for the first time are reluctant to take detailed precautions and do not trust aid workers.
The risk of a flare-up is still very real. Nearly 150 people were in close contact with the new victims, so they are at risk of infection. Beyond that, more than 200 people who had brief contact with one victim, maybe sharing a taxi, cannot be traced at all.
“We are all holding our breath, frankly,” said Christopher Dye, director of strategy at the World Health Organisation who heads the Ebola epidemiology response.
Officials in Sierra Leone are particularly on edge. Their border is less than 30km from the new cases in Guinea, and the flow of people across porous national boundaries is a chief reason the virus was able to spread throughout the region so easily.
Fofana came to Tana himself on a search mission.
“A woman is missing and I can’t understand why,” he shouted, castigating residents to monitor the sick.
The woman, Aminata Camara, had cared for a friend who died of Ebola, making her a likely next victim. Then Camara vanished. No one offered any clues, so the authorities jailed her husband, meaning to convey the seriousness of the problem. Fofana declared that if she did not turn up soon, he would fire the village chief.
But while the unco-operative witness here in Forécariah prefecture was jailed, others who have been in close contact with highly contagious patients roam freely.
There are other mysteries to solve.
Victims have turned up out of nowhere, exposing either flaws in the plan to contain the disease or, just as troubling, the possibility that the virus is spreading through survivors, most likely through semen, a transmission path suspected in a case here.
“The aftermath coming out of Ebola disease is something unknown to just about everybody,” said Jean-Vivien Mombouli, a top Ebola adviser to the government.
The gravity of the situation is evident in the tiny village of Tana, where more than 100 international health workers, community volunteers and even anthropologists have moved into giant white tents close to the doorsteps of recent victims, with a task that has eluded some of the world’s top medical minds. So far, their strategy has not worked.
That Guinea was never hit as hard as Sierra Leone or Liberia may also explain why Ebola has been so difficult to wipe out here.
“In Guinea, we never had this apocalyptic transmission like in Liberia and Sierra Leone; we never had bodies in the streets,” said Ranu Dhillon, a public health expert at the president’s office. “We never had that same kind of critical moment in terms of national response.” — NYTimes.com
We never had this apocalyptic transmission; we never had bodies in the streets